-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DruA/E4kxgzJCDedpYCJFxH4KQ+Q9uPwT61D7hhF5RYFUWM1PiJ8DdAV7E/Tu/SS pMNvw5XbSU5PbcHVQ/RIEQ== 0001116502-01-500505.txt : 20010521 0001116502-01-500505.hdr.sgml : 20010521 ACCESSION NUMBER: 0001116502-01-500505 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010518 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: 21ST CENTURY HOLDING CO CENTRAL INDEX KEY: 0001069996 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 650248866 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-55363 FILM NUMBER: 1643791 BUSINESS ADDRESS: STREET 1: 4161 N W 5TH STREET CITY: PLANTATION STATE: FL ZIP: 33317 BUSINESS PHONE: 9545819993 MAIL ADDRESS: STREET 1: 4161 N W 5TH STREET CITY: PLANTATION STATE: FL ZIP: 33317 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HILLIARD FAMILY FOUNDATION INC CENTRAL INDEX KEY: 0001140904 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 302 N. ADAMS ST. STREET 2: SUITE 100 CITY: GREEN BAY STATE: WI ZIP: 54301-5144 BUSINESS PHONE: 9204320800 MAIL ADDRESS: STREET 1: 302 N. ADAMS ST. STREET 2: SUITE 100 CITY: GREEN BAY STATE: WI ZIP: 54301-5144 SC 13G 1 hfamily-sc13g.txt SCHEDULE 13G UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 21st CENTURY HOLDING COMPANY - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, $.01 Par Value - -------------------------------------------------------------------------------- (Title of Class of Securities) 90136Q100 - -------------------------------------------------------------------------------- (CUSIP Number) 05/09/01 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [X] Rule 13d-1(c) [ ] Rule 13d-1(d) CUSIP No. 90136Q100 1 NAMES OF REPORTING PERSONS Hilliard Family Foundation, Inc. ------------------------------------------ S.S. OR I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS ------------------ 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [ ] (b) [ ] 3 SEC USE ONLY -------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S.A. -------------------------------- NUMBER OF 5 SOLE VOTING POWER 199,800 SHARES ---------------------- BENEFICIALLY 6 SHARED VOTING POWER 0 OWNED BY --------------------- EACH 7 SOLE DISPOSITIVE POWER 199,800 REPORTING ------------------ PERSON 8 SHARED DISPOSITIVE POWER 0 WITH: --------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 199,800 -------- 10 CHECK IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 6.3 (1) ------------------- 12 TYPE OF REPORTING PERSON (See Instructions) CO ------------------------- 1 Calculated on the basis of 3,165,201 shares of Common Stock outstanding on May 9, 2001. Item 1(a). Name of Issuer: 21st Century Holding Company Item 1(b). Address of Issuer's Principal Executive Offices: 4161 NW 5th Street Plantation, FL 33317 Item 2(a). Name of Person Filing: Hilliard Family Foundation, Inc. Item 2(b). Address of Principal Business Office or, if none, Residence: 8040 Willard Drive, Suite 205 Green Bay, WI 54304 Item 2(c). Citizenship: See Item 4 on Cover Page U.S.A. Item 2(d). Title of Class of Securities: Common Stock, $.01 Par Value Item 2(e). CUSIP Number: 90136Q100 Item 3 If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b), check whether the person filing is a: Corporation Item 4. Ownership: (a) Amount Beneficially Owned: 199,800 shares. -------------------------- (b) Percent of Class: 6.3 (1) ------------------------------------ 1 Calculated on the basis of 3,165,201 shares of Common Stock outstanding on May 9, 2001.
(c) Number of shares as to which such person has: (i) sole power to vote or to direct to vote 199,800 shares ------------------------- (ii) shared power to vote or to direct the vote 0 -------------------------- (iii) sole power to dispose or to direct the disposition of 199,800 shares -------------------------- (iv) shared power to dispose or to direct disposition of 0 --------------------------
Item 5. Ownership of Five Percent or Less of a Class: If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following |_| Item 6. Ownership of More than Five Percent on Behalf of Another Person: Not applicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company: Not applicable. Item 8. Identification and Classification of Members of the Group: Not applicable. Item 9. Notice of Dissolution of Group: Not applicable. Item 10. Certification: By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Dated: May 18, 2001. /s/ Timothy Day ----------------- Timothy Day, Secretary -----END PRIVACY-ENHANCED MESSAGE-----