0001214659-23-015448.txt : 20231121
0001214659-23-015448.hdr.sgml : 20231121
20231121160232
ACCESSION NUMBER: 0001214659-23-015448
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: Knutzen Jonathan
CENTRAL INDEX KEY: 0001808325
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38873
FILM NUMBER: 231427998
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]
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-63576.xml
PRIMARY DOCUMENT
X0508
4
2023-11-18
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
11618
D
Common Stock (RSUs)
2023-11-18
4
M
false
2447
0.00
A
14065
D
Common Stock (RSUs)
2023-11-18
4
S
false
754
59.1000
D
13311
D
Restricted Stock Units
0.00
2023-11-18
4
M
false
2447
0.00
D
Common Stock
2447
7343
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 1,255 shares purchased pursuant to the Palomar Holdings, Inc. 2019 Employee Stock Purchase Plan (ESPP).
The original RSU grant was for 12,238 shares on 11/18/2021. Subject to continuing service with the Company, the restricted stock units shall vest as follows: 2,448 units shall vest on the first year anniversary of the date of the grant; 2,447 units shall vest on the second year anniversary of the date of the grant; 2,447 units shall vest on the third year anniversary of the date of grant; and 612 units shall vest quarterly following the third anniversary date of the grant.
/s/ Angela Grant, Attorney-in-Fact
2023-11-20