0001753647-18-000001.txt : 20180920 0001753647-18-000001.hdr.sgml : 20180920 20180920145145 ACCESSION NUMBER: 0001753647-18-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180920 DATE AS OF CHANGE: 20180920 EFFECTIVENESS DATE: 20180920 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Palomar Insurance Holdings, Inc. CENTRAL INDEX KEY: 0001753647 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-321838 FILM NUMBER: 181079316 BUSINESS ADDRESS: STREET 1: 7979 IVANHOE AVENUE, SUITE 500 CITY: LA JOLLA STATE: CA ZIP: 92037 BUSINESS PHONE: 619-567-5290 MAIL ADDRESS: STREET 1: 7979 IVANHOE AVENUE, SUITE 500 CITY: LA JOLLA STATE: CA ZIP: 92037 D 1 primary_doc.xml X0708 D LIVE 0001753647 Palomar Insurance Holdings, Inc. 7979 IVANHOE AVENUE, SUITE 500 LA JOLLA CA CALIFORNIA 92037 619-567-5290 DELAWARE Cottage Insurance Holdings, Inc. None Corporation true 2013 Toshio Christopher Uchida 7979 Ivanhoe Avenue, Suite 500 La Jolla CA CALIFORNIA 92037 Executive Officer Insurance Decline to Disclose 06b false 2018-09-06 false true false 100000 20000000 20000000 0 false 6 0 0 0 false Palomar Insurance Holdings, Inc. /s/ Toshio Christopher Uchida Toshio Christopher Uchida Chief Financial Officer 2018-09-20