0001104659-20-068549.txt : 20200601
0001104659-20-068549.hdr.sgml : 20200601
20200601192148
ACCESSION NUMBER: 0001104659-20-068549
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200528
FILED AS OF DATE: 20200601
DATE AS OF CHANGE: 20200601
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Notaras Martha
CENTRAL INDEX KEY: 0001803071
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38873
FILM NUMBER: 20935260
MAIL ADDRESS:
STREET 1: 7979 IVANHOE AVENUE, SUITE 500
CITY: LA JOLLA
STATE: CA
ZIP: 92037
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Palomar Holdings, Inc.
CENTRAL INDEX KEY: 0001761312
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 7979 IVANHOE AVENUE
STREET 2: SUITE 500
CITY: LA JOLLA
STATE: CA
ZIP: 92037
BUSINESS PHONE: 619-567-5290
MAIL ADDRESS:
STREET 1: 7979 IVANHOE AVENUE
STREET 2: SUITE 500
CITY: LA JOLLA
STATE: CA
ZIP: 92037
FORMER COMPANY:
FORMER CONFORMED NAME: GC Palomar Holdings
DATE OF NAME CHANGE: 20181211
4
1
a4.xml
4
X0306
4
2020-05-28
0
0001761312
Palomar Holdings, Inc.
PLMR
0001803071
Notaras Martha
7979 IVANHOE AVENUE, SUITE 500
LA JOLLA
CA
92037
1
0
0
0
Common Stock (RSUs)
2020-05-28
4
A
0
334
0
A
459
D
The amount reported reflects Restricted Stock Units (RSUs) granted to the Reporting Person pursuant to the Issuer's 2019 Equity Incentive Plan (the "Plan"), which shall vest upon the earlier of (i) the twelve month anniversary of the "Grant Date/Vesting Base Date" and (ii) immediately prior to the Issuer's 2021 Annual Meeting, subject to the Reporting Person's continuing Service (as defined in the Plan) with the Issuer.
/s/ Christopher Uchida, Attorney-in-Fact
2020-05-29