Sec Form 4 Filing - Moldow Charles @ Doma Holdings, Inc. - 2024-09-27

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED 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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Moldow Charles
2. Issuer Name and Ticker or Trading Symbol
Doma Holdings, Inc. [ DOMA]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
101 MISSION STREET, SUITE 1050
3. Date of Earliest Transaction (MM/DD/YY)
09/27/2024
(Street)
SAN FRANCISCO, CA94105
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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)
Code V Amount (A) or (D) Price
Common Stock 09/27/2024 D( 1 ) 1,341,357 D $ 6.29 ( 2 ) 0 I By Foundation Capital VIII, L.P. ( 3 )
Common Stock 09/27/2024 D( 1 ) 28,891 D $ 6.29 ( 2 ) 0 I By Foundation Capital VIII Principals Fund, L.L.C. ( 3 )
Common Stock 09/27/2024 D( 1 ) 420,838 D $ 6.29 ( 2 ) 0 I By Foundation Capital Leadership Fund II, L.P. ( 3 )
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Moldow Charles
101 MISSION STREET, SUITE 1050
SAN FRANCISCO, CA94105
X
Signatures
/a/ Charles Moldow 12/09/2024
Signature of Reporting Person Date
Explanation of Responses:
( 1 )On September 27, 2024, RE Closing Buyer Corp. ("Parent") acquired the Issuer pursuant to that certain Agreement and Plan of Merger (the "Merger Agreement"), dated as of March 28, 2024, by and among the Issuer, Parent, and RE Closing Merger Sub Inc., a wholly-owned subsidiary of Parent ("Merger Sub"). In accordance with the Merger Agreement, Merger Sub merged with and into the Issuer, with the Issuer surviving such merger as a wholly-owned subsidiary of Parent (the "Merger").
( 2 )As of the effective time of the Merger (the "Effective Time"), pursuant to the Merger Agreement, each share of the Issuer's common stock outstanding immediately prior to the Effective Time was automatically cancelled and converted into the right to receive $6.29 in cash (the "Merger Consideration").
( 3 )Foundation Capital Management Co. LF II, L.L.C. is the general partner of Foundation Capital Leadership Fund II, L.P. Foundation Capital Management Co. VIII, L.L.C. is the manager of Foundation Capital VIII Principals Fund, L.L.C. and the general partner of Foundation Capital VIII, L.P. The Reporting Person is a manager of each of Foundation Capital Management Co. LF II, L.L.C. and Foundation Capital Management Co. VIII, L.L.C. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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