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DOMA HOLDINGS, INC.

Date Filed : Jul 30, 2021

SEC FORM 4SEC Form 4
FORM 4UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Morrison Christopher T

(Last)(First)(Middle)
101 MISSION ST. SUITE 740

(Street)
SAN FRANCISCOCA94105

(City)(State)(Zip)
2. Issuer Name and Ticker or Trading Symbol
Doma Holdings, Inc. [ DOMA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director10% Owner
XOfficer (give title below)Other (specify below)
Chief Operating Officer
3. Date of Earliest Transaction (Month/Day/Year)
07/28/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
XForm filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year)2A. Deemed Execution Date, if any (Month/Day/Year)3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeVAmount(A) or (D)Price
Common Stock07/28/2021A1,586,141A(1)1,586,141D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year)3A. Deemed Execution Date, if any (Month/Day/Year)4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year)7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Stock Options (Right to Buy)$0.0307/28/2021A287,990 (2)05/31/2028Common stock287,990(2)287,990D
Stock Options (Right to Buy)$0.4507/28/2021A1,679,732 (3)04/15/2029Common stock1,679,732(3)1,679,732D
Stock Options (Right to Buy)$0.4507/28/2021A419,927 (4)04/15/2029Common stock419,927(4)419,927D
Stock Options (Right to Buy)$0.7107/28/2021A299,746 (5)06/02/2030Common stock299,746(5)299,746D
Stock Options (Right to Buy)$0.7107/28/2021A29,974 (6)01/27/2031Common stock29,974(6)29,974D
Explanation of Responses:
1. Received in exchange for shares of common stock of Doma Holdings, Inc., which was formerly known as States Title Holding, Inc. ("Former Doma") in connection with the merger by and among Capitol Investment Corp V., Capitol V Merger Sub, Inc. and Former Doma (the "Merger").
2. The option vests in 20% on the first anniversary of May 1, 2018 and in equal monthly installments thereafter until it is fully vested on the fifth anniversary of such date. The stock option was received in the Merger in exchange for a stock option to acquire shares of Former Doma common stock.
3. The option vests in 25% on the first anniversary of January 7, 2019 and in equal monthly installments thereafter until it is fully vested on the fourth anniversary of such date. The stock option was received in the Merger in exchange for a stock option to acquire shares of Former Doma common stock.
4. The option vests in 25% on the first anniversary of January 7, 2019 and in equal monthly installments thereafter until it is fully vested on the fourth anniversary of such date. The stock option was received in the Merger in exchange for a stock option to acquire shares of Former Doma common stock.
5. The option vests in 25% on the first anniversary of December 1, 2019 and in equal monthly installments thereafter until it is fully vested on the fourth anniversary of such date. The stock option was received in the Merger in exchange for a stock option to acquire shares of Former Doma common stock.
6. The option vests in 25% on the first anniversary of March 1, 2021 and in equal monthly installments thereafter until it is fully vested on the fourth anniversary of such date. The stock option was received in the Merger in exchange for a stock option to acquire shares of Former Doma common stock.
/s/ Christian Ameri, as Attorney-in-Fact for Christopher Morrison07/30/2021
** Signature of Reporting PersonDate
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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