0001209191-21-031212.txt : 20210510 0001209191-21-031212.hdr.sgml : 20210510 20210510160500 ACCESSION NUMBER: 0001209191-21-031212 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210427 FILED AS OF DATE: 20210510 DATE AS OF CHANGE: 20210510 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: List Teri CENTRAL INDEX KEY: 0001529370 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40349 FILM NUMBER: 21907048 MAIL ADDRESS: STREET 1: 2200 PENNSYLVANIA AVENUE STREET 2: SUITE 800W CITY: WASHINGTON STATE: DC ZIP: 20037 FORMER NAME: FORMER CONFORMED NAME: List-Stoll Teri DATE OF NAME CHANGE: 20180306 FORMER NAME: FORMER CONFORMED NAME: List Teri L. DATE OF NAME CHANGE: 20110907 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DoubleVerify Holdings, Inc. CENTRAL INDEX KEY: 0001819928 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 822714562 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 233 SPRING STREET CITY: NEW YORK STATE: NY ZIP: 10013 BUSINESS PHONE: 212-631-2111 MAIL ADDRESS: STREET 1: 233 SPRING STREET CITY: NEW YORK STATE: NY ZIP: 10013 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-04-27 0 0001819928 DoubleVerify Holdings, Inc. DV 0001529370 List Teri C/O DOUBLEVERIFY HOLDINGS, INC. 233 SPRING STREET NEW YORK NY 10013 1 0 0 0 Common Stock 2021-04-27 4 M 0 31008 A 45439 D Restricted Stock Units 2021-04-27 4 M 0 31008 0.00 D 2021-04-27 Common Stock 31008 0 D Each restricted stock unit ("RSU") was granted on April 27, 2020 and represents a right to receive one share of common stock on a one-to-one basis. The RSUs fully vested on April 27, 2021. Restricted stock units convert into common stock on a one-for-one basis. /s/ Andrew E. Grimmig, as Attorney-in-Fact for Teri L. List 2021-05-07