Sec Form 3 Filing - Foundation Capital VIII, L.P. @ Doma Holdings, Inc. - 2021-07-28

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FORM 3
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
Foundation Capital VIII, L.P.
2. Issuer Name and Ticker or Trading Symbol
Doma Holdings, Inc. [ DOMA]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
550 HIGH STREET, 3RD FLOOR
3. Date of Earliest Transaction (MM/DD/YY)
07/28/2021
(Street)
PALO ALTO, CA94301
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ 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 33,533,929 ( 1 ) D
Common Stock 722,769 ( 2 ) D
Common Stock 10,520,957 ( 3 ) D
Expiration Date
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 Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Foundation Capital VIII, L.P.
550 HIGH STREET, 3RD FLOOR
PALO ALTO, CA94301
X
Foundation Capital VIII Principals Fund, L.L.C.
550 HIGH STREET, 3RD FLOOR
PALO ALTO, CA94301
X
Foundation Capital Management Co. VIII, L.L.C.
550 HIGH STREET, 3RD FLOOR
PALO ALTO, CA94301
X
Foundation Capital Leadership Fund II, L.P.
550 HIGH STREET, 3RD FLOOR
PALO ALTO, CA94301
X
Foundation Capital Management Co. LF II, L.L.C.
550 HIGH STREET, 3RD FLOOR
PALO ALTO, CA94301
X
Signatures
Foundation Capital VIII, L.P., By: Foundation Capital Management Co. VIII, L.L.C., its General Partner, By: /s/ Charles Moldow, Manager 08/09/2021
Signature of Reporting Person Date
Foundation Capital VIII Principals Fund, L.L.C., By: Foundation Capital Management Co. VIII, L.L.C., its Manager, By: /s/ Charles Moldow, Manager 08/09/2021
Signature of Reporting Person Date
Foundation Capital Management Co. VIII, L.L.C., By: /s/ Charles Moldow, Manager 08/09/2021
Signature of Reporting Person Date
Foundation Capital Leadership Fund II, L.P., By: Foundation Capital Management Co. LF II, L.L.C., its General Partner, By: /s/ Charles Moldow, Manager 08/09/2021
Signature of Reporting Person Date
Foundation Capital Management Co. LF II, L.L.C., By: Charles Moldow, Manager 08/09/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )These securities are owned by Foundation Capital VIII, L.P. ("FC8"). Foundation Capital Management Co,. VIII, L.L.C. ("FCM8") serves as the sole general partner of FC8 and, as such, FCM8 possesses voting and dispositive power over the shares held by FC8, and may be deemed to have indirect beneficial ownership of the shares held by FC8. FCM8 disclaims beneficial ownership of such securities except to the extent of its pecuniary interest therein.
( 2 )These securities are owned by Foundation Capital VIII Principals Fund, LLC ("FC8P"). FCM8 serves as the sole manager of FC8P and, as such, FCM8 possesses voting and dispositive power over the shares held by FC8P, and may be deemed to have indirect beneficial ownership of the shares held by FC8P. FCM8 disclaims beneficial ownership of such securities except to the extent of its pecuniary interest therein.
( 3 )These securities are owned by Foundation Capital Leadership Fund II, L.P. ("FCL2"), Foundation Capital Management Co,. LF II, L.L.C. ("FCMLF2") serves as the sole general partner of FCL2 and, as such, FCMLF2 possesses voting and dispositive power over the shares held by FCL2, and may be deemed to have indirect beneficial ownership of the shares held by FCL2. FCMLF2 disclaims beneficial ownership of such securities except to the extent of its pecuniary interest therein.

Remarks:
The Reporting Persons expressly disclaim membership in any "group" for purposes of Section 13 or Section 16 of the Securities Exchange Act, and the filing of this Form 3 shall not be deemed an admission that the Reporting Persons or their affiliates are members of such a group.

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).

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