0001722438-22-000082.txt : 20220701
0001722438-22-000082.hdr.sgml : 20220701
20220701164938
ACCESSION NUMBER: 0001722438-22-000082
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220629
FILED AS OF DATE: 20220701
DATE AS OF CHANGE: 20220701
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: 221062090
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: 221062089
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_165670856424045.xml
FORM 4
X0306
4
2022-06-29
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
2022-06-29
4
A
0
2435325
0
A
2937461
D
Common stock
2022-06-29
4
A
0
2435325
0
A
5372786
D
Common stock
48053275
I
By The Saslaw-Simkoff Revocable Trust
Common stock
346609
I
By Max Simkoff 2020 GRAT
Common stock
346609
I
By Jennifer Saslaw 2020 GRAT
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 "Date of Grant" is June 29, 2022. These RSUs will be settled solely by delivery of shares of Company common stock and vest as follows: 1/16th of the total RSUs will vest on each successive Scheduled Vesting Date (as defined below) following the Date of Grant, with the "Scheduled Vesting Date" being September 1, December 1, March 1 and June 1 of the applicable year, provided the reporting person is continuously employed through such date as applicable, with the first 1/16th of the RSUs vesting on September 1, 2022 and the final 1/16th of the RSUs vesting on September 1, 2026.
Grant of Company common stock to the reporting person in the form of performance restricted stock units ("PRSUs") pursuant to the Plan. The PRSUs will be settled solely by delivery of shares of Company common stock. The PRSUs will vest subject to the satisfaction of a (A) service requirement on the following schedule: 1/16th of the PRSUs will vest on September 1, December 1, March 1 and June 1 of the applicable year, provided the reporting person is continuously employed through such date as applicable, with the first 1/16th of PRSUs vesting on September 1, 2022 and the final 1/16th of PRSUs vesting on September 1, 2026; and (B) performance condition during the period beginning on June 29, 2022 and ending on June 1, 2026, pursuant to which the Company achieves a price hurdle of $5.00 (as to 1/3 of the target PRSUs), $7.00 (as to 1/3 of the target PRSUs) and $10.00 (as to 1/3 of the target PRSUs) based on the 90-day volume weighted average price of the Company's common stock.
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.
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 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.
/s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff
2022-07-01
/s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff, Trustee
2022-07-01