0001104659-21-021910.txt : 20210212 0001104659-21-021910.hdr.sgml : 20210212 20210212160844 ACCESSION NUMBER: 0001104659-21-021910 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201231 FILED AS OF DATE: 20210212 DATE AS OF CHANGE: 20210212 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Harley Joshua CENTRAL INDEX KEY: 0001817237 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39412 FILM NUMBER: 21627318 MAIL ADDRESS: STREET 1: C/O FATHOM HOLDINGS INC. STREET 2: 211 NEW EDITION COURT, SUITE 211 CITY: CARY STATE: NC ZIP: 27511 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fathom Holdings Inc. CENTRAL INDEX KEY: 0001753162 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE AGENTS & MANAGERS (FOR OTHERS) [6531] IRS NUMBER: 821518164 STATE OF INCORPORATION: NC FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 211 NEW EDITION COURT STREET 2: SUITE 211 CITY: CARY STATE: NC ZIP: 27511 BUSINESS PHONE: (919) 434-3975 MAIL ADDRESS: STREET 1: 211 NEW EDITION COURT STREET 2: SUITE 211 CITY: CARY STATE: NC ZIP: 27511 5 1 tm216324-2_5seq1.xml OWNERSHIP DOCUMENT X0306 5 2020-12-31 0 0 0 0001753162 Fathom Holdings Inc. FTHM 0001817237 Harley Joshua C/O FATHOM HOLDINGS INC. 211 NEW EDITION COURT, SUITE 211 CARY NC 27511 1 1 1 0 Chief Executive Officer Common Stock 2020-08-18 5 G 0 19285 0 D 3270682 D Common Stock 2020-10-28 5 G 0 10532 0 D 3260150 D Common Stock 1705304 I See footnote Includes an aggregate of 1,700,000 shares held by three trust for which Mr. Harley serves as a trustee, and 5,304 shares held for the benefit of a stepchild. /s/ Donald R. Reynolds, by Power of Attorney 2021-02-12