0001722438-22-000179.txt : 20220929 0001722438-22-000179.hdr.sgml : 20220929 20220929171041 ACCESSION NUMBER: 0001722438-22-000179 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220928 FILED AS OF DATE: 20220929 DATE AS OF CHANGE: 20220929 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: 221281436 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: 221281435 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_166448581982305.xml FORM 4 X0306 4 2022-09-28 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 2022-09-28 4 S 0 56227 0.511 D 46834152 I By The Saslaw-Simkoff Revocable Trust Common stock 5291560 D Common stock 346609 I By Max Simkoff 2020 GRAT Common stock 346609 I By Jennifer Saslaw 2020 GRAT This transaction was made pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on May 13, 2022. The price reported above in Column 4 represents a weighted average sales price. This transaction was executed in multiple trades at prices ranging from $0.50 to $0.55, inclusive. The reporting person hereby undertakes to provide, upon request, to Doma Holdings, Inc. (the "Issuer"), any security holder of the Issuer, or the staff of the Securities and Exchange Commission, full information regarding the number of shares and prices at which the transaction was effected. 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 2022-09-29 /s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff, Trustee 2022-09-29