Sec Form 4 Filing - Grant Angela L. @ Palomar Holdings, Inc. - 2023-01-26

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
Grant Angela L.
2. Issuer Name and Ticker or Trading Symbol
Palomar Holdings, Inc. [ PLMR]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Legal Officer
(Last) (First) (Middle)
7979 IVANHOE AVENUE, SUITE 500
3. Date of Earliest Transaction (MM/DD/YY)
01/26/2023
(Street)
LA JOLLA, CA92037
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 265( 2 ) D
Common Stock (RSUs) 01/26/2023 M 656 A $ 0 921( 2 ) D
Common Stock (RSUs) 01/26/2023 F( 1 ) 271 D $ 49.5397 650( 2 ) D
Common Stock (RSUs) 01/26/2023 M 1,312 A $ 0 1,962( 2 ) D
Common Stock (RSUs) 01/26/2023 F( 1 ) 541 D $ 49.5405 1,421( 2 ) D
Common Stock (RSUs) 01/27/2023 M 248 A $ 0 1,669( 2 ) D
Common Stock (RSUs) 01/27/2023 F( 1 ) 103 D $ 49.18 1,566( 2 ) D
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
Restricted Stock Units $ 0 01/26/2023 M 656 ( 3 ) ( 3 ) Common Stock 656 $ 0 1,312 D
Restricted Stock Units $ 0 01/26/2023 M 1,312 ( 4 ) ( 4 ) Common Stock 1,312 $ 0 2,625 D
Restricted Stock Units $ 0 01/27/2023 M 248 ( 5 ) ( 5 ) Common Stock 248 $ 0 247 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Grant Angela L.
7979 IVANHOE AVENUE, SUITE 500
LA JOLLA, CA92037
Chief Legal Officer
Signatures
/s/ Angela Grant 01/30/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )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.
( 2 )Includes 121 shares purchased pursuant to the Palomar Holdings, Inc. 2019 Employee Stock Purchase Plan (ESPP).
( 3 )The original RSU grant was for 1,968 shares on 1/26/2022. 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.
( 4 )The original RSU grant was for 3,937 shares on 1/26/2022. 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.
( 5 )The original RSU grant was for 742 shares on 1/27/2021. 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.

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