0001214659-24-001805.txt : 20240202
0001214659-24-001805.hdr.sgml : 20240202
20240202193931
ACCESSION NUMBER: 0001214659-24-001805
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240131
FILED AS OF DATE: 20240202
DATE AS OF CHANGE: 20240202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Johnson Michelle Antoinette
CENTRAL INDEX KEY: 0001808996
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38873
FILM NUMBER: 24593514
MAIL ADDRESS:
STREET 1: 7979 IVANHOE AVENUE, 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]
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-64553.xml
PRIMARY DOCUMENT
X0508
4
2024-01-31
0001761312
Palomar Holdings, Inc.
PLMR
0001808996
Johnson Michelle Antoinette
7979 IVANHOE AVENUE, SUITE 500
LA JOLLA
CA
92037
false
true
false
false
Chief People & Prod. Officer
0
Common Stock
3329
D
Common Stock (RSUs)
2024-01-31
4
M
false
692
0.00
A
4021
D
Common Stock (RSUs)
2024-01-31
4
S
false
250
59.1902
D
3771
D
Restricted Stock Units (RSUs)
0.00
2024-01-31
4
M
false
692
0.00
D
Common Stock
692
1385
D
Restricted Stock Units (RSUs)
0.00
2023-01-31
4
A
false
2077
0.00
A
Common Stock
2077
2077
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 349 shares purchased pursuant to the Palomar Holdings, Inc. 2019 Employee Stock Purchase Plan (ESPP).
The original RSU grant was for 2,077 shares on 1/31/2023. Subject to continuing service with the Company, the restricted stock units shall vest as follows: one-third (1/3) shall vest on the first year anniversary of the date of the grant; an additional one-third (1/3) shall vest on the second year anniversary of the date of the grant; and the final one-third (1/3) shall vest on the third year anniversary of the date of grant.
/s/ Angela Grant, Attorney-in-Fact
2024-02-02