0001214659-24-000211.txt : 20240103
0001214659-24-000211.hdr.sgml : 20240103
20240103184315
ACCESSION NUMBER: 0001214659-24-000211
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240101
FILED AS OF DATE: 20240103
DATE AS OF CHANGE: 20240103
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Knutzen Jonathan
CENTRAL INDEX KEY: 0001808325
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38873
FILM NUMBER: 24508927
MAIL ADDRESS:
STREET 1: 7979 IVANHOE AVENUE, SUITE 500
CITY: LA JOLLA
STATE: CA
ZIP: 92121
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Palomar Holdings, Inc.
CENTRAL INDEX KEY: 0001761312
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
ORGANIZATION NAME: 02 Finance
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-64008.xml
PRIMARY DOCUMENT
X0508
4
2024-01-01
0001761312
Palomar Holdings, Inc.
PLMR
0001808325
Knutzen Jonathan
7979 IVANHOE AVENUE, SUITE 500
LA JOLLA
CA
92037
false
true
false
false
Chief Risk Officer
0
Common Stock
13311
D
Common Stock (PSUs)
2024-01-01
4
M
false
650
0.00
A
13961
D
Common Stock (PSUs)
2024-01-01
4
S
false
162
54.5128
D
13799
D
Common Stock (PSUs)
2024-01-01
4
S
false
77
54.5142
D
13722
D
Includes 1,255 shares purchased pursuant to the Palomar Holdings, Inc. 2019 Employee Stock Purchase Plan (ESPP).
Represents the date on which previously granted performance stock unit ("PSU") awards were determined to be vested based on the grantee completing the required service period.
Represents the number of shares of common stock determined to have been earned and vested from a previously granted PSU award. The PSU award was granted on 1/27/2021 and the number of shares that vested was based on achievement of certain company financial performance criteria and the grantee completing the required service period through 1/1/2024.
Represents shares automatically sold by the Company on behalf of the Reporting Person pursuant to a mandatory sell-to-cover provision in the PSU award agreement required to cover minimum statutory tax withholding obligations that became due upon the PSU vesting event.
/s/ Angela Grant, Attorney-in-Fact
2024-01-03