0001104659-21-057543.txt : 20210429
0001104659-21-057543.hdr.sgml : 20210429
20210429160453
ACCESSION NUMBER: 0001104659-21-057543
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210305
FILED AS OF DATE: 20210429
DATE AS OF CHANGE: 20210429
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Harley Joshua
CENTRAL INDEX KEY: 0001817237
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39412
FILM NUMBER: 21870422
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: 2000 REGENCY PARKWAY DRIVE
STREET 2: SUITE 300
CITY: CARY
STATE: NC
ZIP: 27518
BUSINESS PHONE: 8884556040
MAIL ADDRESS:
STREET 1: 2000 REGENCY PARKWAY DRIVE
STREET 2: SUITE 300
CITY: CARY
STATE: NC
ZIP: 27518
4
1
tm2114633-5_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-03-05
0
0001753162
Fathom Holdings Inc.
FTHM
0001817237
Harley Joshua
C/O FATHOM HOLDINGS INC.
2000 REGENCY PARKWAY DRIVE, SUITE 300
CARY
NC
27518
1
1
0
0
Chief Executive Officer
Common Stock
2021-03-05
4
A
0
9558
0
A
3269708
D
Common Stock
1700000
I
See footnote
Of these shares, 9,558 shares are restricted and vest in full on March 4, 2024.
Includes an aggregate of 1,700,000 shares held by three trusts for which Mr. Harley serves as a trustee.
A previous Form 5 mistakenly reported 5,304 shares held indirectly for the benefit of a stepchild. This disclosure was made in error and the shares have been removed.
/s/ Donald R. Reynolds, by Power of Attorney
2021-04-29