0001214659-21-009574.txt : 20210916 0001214659-21-009574.hdr.sgml : 20210916 20210916180729 ACCESSION NUMBER: 0001214659-21-009574 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210915 FILED AS OF DATE: 20210916 DATE AS OF CHANGE: 20210916 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Uchida T Christopher CENTRAL INDEX KEY: 0001772379 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38873 FILM NUMBER: 211258822 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-53819.xml PRIMARY DOCUMENT X0306 4 2021-09-15 0001761312 Palomar Holdings, Inc. PLMR 0001772379 Uchida T Christopher 7979 IVANHOE AVENUE, SUITE 500 LA JOLLA CA 92037 false true false false Chief Financial Officer Common Stock 2021-09-15 4 M false 1500 15.00 A 33391 D Common Stock 2021-09-15 4 S false 1500 86.11 D 31891 D Common Stock 2021-09-15 4 S false 400 86.11 D 31491 D Employee Stock Option (Right to Buy) 15.00 2021-09-15 4 M false 1500 0.00 D 2029-04-16 Common Stock 1500 24156 D The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan. Includes 1,337 shares of Common Stock purchased pursuant to the Palomar Holdings, Inc. 2019 Employee Stock Purchase Plan (ESPP). Fifty percent (50%) of the option shares vest and become exercisable on April 16, 2020 and the remaining option shares vest and become exercisable in twelve (12) equal monthly installments thereafter. /s/ Christopher Uchida 2021-09-16