0001722438-22-000034.txt : 20220401 0001722438-22-000034.hdr.sgml : 20220401 20220401165057 ACCESSION NUMBER: 0001722438-22-000034 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220330 FILED AS OF DATE: 20220401 DATE AS OF CHANGE: 20220401 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simkoff Maxwell CENTRAL INDEX KEY: 0001868802 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39754 FILM NUMBER: 22799044 MAIL ADDRESS: STREET 1: 101 MISSION ST. STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Saslaw-Simkoff Revocable Trust CENTRAL INDEX KEY: 0001875424 STATE OF INCORPORATION: CA FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39754 FILM NUMBER: 22799043 BUSINESS ADDRESS: STREET 1: 101 MISSION ST. STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 703-789-5646 MAIL ADDRESS: STREET 1: 101 MISSION ST. STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Doma Holdings, Inc. CENTRAL INDEX KEY: 0001722438 STANDARD INDUSTRIAL CLASSIFICATION: TITLE INSURANCE [6361] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 101 MISSION STREET STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: (650) 419-3827 MAIL ADDRESS: STREET 1: 101 MISSION STREET STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 FORMER COMPANY: FORMER CONFORMED NAME: Capitol Investment Corp. V DATE OF NAME CHANGE: 20171113 4 1 wf-form4_164884624094729.xml FORM 4 X0306 4 2022-03-30 0 0001722438 Doma Holdings, Inc. DOMA 0001868802 Simkoff Maxwell 101 MISSION ST. SUITE 740 SAN FRANCISCO CA 94105 1 1 1 0 Chief Executive Officer 0001875424 Saslaw-Simkoff Revocable Trust 101 MISSION ST. SUITE 740 SAN FRANCISCO CA 94105 0 0 1 0 Common stock 2022-03-30 4 G 0 358683 0 D 346609 I By Jennifer Saslaw 2020 GRAT Common stock 2022-03-30 4 G 0 358683 0 D 346609 I By Max Simkoff 2020 GRAT Common stock 2022-03-30 4 G 0 717366 0 A 48053275 I By The Saslaw-Simkoff Revocable Trust Common stock 2022-03-31 4 A 0 502136 0 A 502136 D 358,683 shares of Company common stock were previously owned by each of the Jennifer Saslaw 2020 GRAT and the Max Simkoff 2020 GRAT. These shares were distributed in the form of an annuity payment pursuant to the terms of the GRATS and subsequently transferred to The Saslaw-Simkoff Revocable Trust for no consideration. These shares are held for the benefit of the reporting person's wife. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. These shares are owned directly by the Max Simkoff 2020 GRAT. The reporting person disclaims beneficial ownership except to the extent of his pecuniary interest therein. These shares are owned directly by The Saslaw-Simkoff Revocable Trust and indirectly by Maxwell Simkoff as trustee of the trust. The reporting person disclaims beneficial ownership except to the extent of his pecuniary interest therein. Grant of Doma Holdings, Inc.'s (the "Company") common stock to the reporting person in the form of restricted stock units ("RSUs") pursuant to the Company's Omnibus Incentive Plan (the "Plan"). The "Vesting Commencement Date" is March 31, 2022. These RSUs will be settled solely by delivery of shares of Company common stock and vest as follows: 25% of the RSUs will vest on the first anniversary of the Vesting Commencement Date and the remainder will vest in 12 consecutive, equal, quarterly installments such that the award is fully vested on the fourth anniversary of the Vesting Commencement Date, provided the reporting person is continuously employed through such date as applicable. /s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff 2022-04-01 /s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff, Trustee 2022-04-01