SEC Form 4 · accession 0001547903-17-000064
NMI Holdings, Inc. · NMIH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
Adam Pollitzer
Officer — EVP, Chief Financial Officer
Period of report
May 10, 2017
Accepted (ET)
May 12, 2017 · 4:34 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001547903
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Restricted Stock Unit (right to receive)F1 | May 10, 2017 | A | 185,185 | $0.00 | A | 185,185 | D | |
| Restricted Stock Unit (right to receive)F2 | May 10, 2017 | A | 23,148 | $0.00 | A | 208,333 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F3 | $10.80 | May 10, 2017 | A | 23,148 | A | — | May 10, 2027 | Class A Common Shares, $0.01 par value per share | 23,148 | 23,148 | D |
Explanation of responses
- F1Represents restricted stock units granted pursuant to the NMIH Amended and Restated 2014 Omnibus Incentive Plan. The shares underlying these restricted stock units vest in five equal annual installments beginning on May 10, 2018.
- F2Represents restricted stock units granted pursuant to the NMIH Amended and Restated 2014 Omnibus Incentive Plan. The shares underlying these restricted stock units vest in three equal annual installments beginning on May 10, 2018.
- F3Granted pursuant to the NMIH 2012 Stock Incentive Plan. The option vests in three equal annual installments beginning on May 10, 2018.