0001214659-23-015449.txt : 20231121
0001214659-23-015449.hdr.sgml : 20231121
20231121160248
ACCESSION NUMBER: 0001214659-23-015449
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231118
FILED AS OF DATE: 20231121
DATE AS OF CHANGE: 20231121
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Christianson Jon
CENTRAL INDEX KEY: 0001772607
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38873
FILM NUMBER: 231428000
MAIL ADDRESS:
STREET 1: 7979 IVANHOE AVENUE
STREET 2: 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
marketforms-63575.xml
PRIMARY DOCUMENT
X0508
4
2023-11-18
0001761312
Palomar Holdings, Inc.
PLMR
0001772607
Christianson Jon
7979 IVANHOE AVENUE, SUITE 500
LA JOLLA
CA
92037
false
true
false
false
President
0
Common Stock
70887
D
Common Stock (RSUs)
2023-11-18
4
M
false
4079
0.00
A
74966
D
Common Stock (RSUs)
2023-11-18
4
S
false
1419
59.10
D
73547
D
Restricted Stock Units
0.00
2023-11-18
4
M
false
4079
0.00
D
Common Stock
4079
12238
D
Represents shares automatically sold by the Company on behalf of the Reporting Person pursuant to a mandatory sell-to-cover provision in the RSU award agreement required to cover minimum statutory tax withholding obligations that became due upon the RSU vesting event.
Includes 1,781 shares purchased pursuant to the Palomar Holdings, Inc. 2019 Employee Stock Purchase Plan (ESPP).
The original RSU grant was for 20,396 shares on 11/18/2021. Subject to continuing service with the Company, the restricted stock units shall vest as follows: 4,079 units shall vest on the first year anniversary of the date of the grant; 4,079 units shall vest on the second year anniversary of the date of the grant; 4,078 units shall vest on the third year anniversary of the date of grant; and 1,020 units shall vest quarterly following the third anniversary date of the grant.
/s/ Angela Grant, Attorney-in-Fact
2023-11-20