0001578563-22-000003.txt : 20220211 0001578563-22-000003.hdr.sgml : 20220211 20220211161512 ACCESSION NUMBER: 0001578563-22-000003 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211231 FILED AS OF DATE: 20220211 DATE AS OF CHANGE: 20220211 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: 22621093 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 5 1 primary_doc.xml PRIMARY DOCUMENT X0306 5 2021-12-31 0 0 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 1 0 Chief Executive Officer Common Stock 2021-12-13 5 G 0 23965 0 D 2913070 D Common Stock 2063032 I See Footnote (1) Includes an aggregate of 1,700,000 shares held by three trusts for which Mr. Harley serves as a trustee. Includes 363,032 shares held in a trust where an immediate family member serves as trustee. /s/ Donald R. Reynolds, by Power of Attorney 2022-02-11