-----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, DCcxHV4i3qefie5cVUrxHtfZmmnSD56MaQpKvFEXsRPd/AIjy0dYE7Vp6kYfY8e9 FNfSWz0Dz8sDuDTwLApe2Q== 0001116502-02-000842.txt : 20020613 0001116502-02-000842.hdr.sgml : 20020613 20020613142401 ACCESSION NUMBER: 0001116502-02-000842 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20020613 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/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-55363 FILM NUMBER: 02678136 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 WALLACE J CENTRAL INDEX KEY: 0001026646 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 4161 NW 5TH STREET CITY: PLANTATION STATE: FL ZIP: 33317 BUSINESS PHONE: 9545819993 MAIL ADDRESS: STREET 1: 4161 NW 5TH STREET CITY: PLANTATION STATE: FL ZIP: 33317 SC 13G/A 1 whilliard-sc13ga5.txt AMENDMENT #5 TO SCHEDULE 13G UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 SCHEDULE 13G (Amendment No. 5) Under the Securities and Exchange Act of 1934 21st Century Holding Company - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, $.01 Par Value - -------------------------------------------------------------------------------- (Title of Class of Securities) 90136Q100 - -------------------------------------------------------------------------------- (CUSIP Number) CUSIP No. 90136Q100 13G Page 2 of 5 Pages ________________________________________________________________________________ 1. NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY) Wallace J. Hilliard ________________________________________________________________________________ 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 SHARES 0 _________________________________________________________________ BENEFICIALLY 6. SHARED VOTING POWER OWNED BY 116,630 (1) _________________________________________________________________ EACH 7. SOLE DISPOSITIVE POWER REPORTING 0 _________________________________________________________________ PERSON 8. SHARED DISPOSITIVE POWER WITH 116,630 (1) ________________________________________________________________________________ 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 116,630 (1) ________________________________________________________________________________ 10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] ________________________________________________________________________________ 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 3.9% (2) ________________________________________________________________________________ 12. TYPE OF REPORTING PERSON* IN ________________________________________________________________________________ *SEE INSTRUCTIONS BEFORE FILLING OUT! - --------------------- 1 Represents 116,630 shares of Common Stock held by the Hilliard Flint Trust. 2 Calculated on the basis of 3,015,501 shares of Common Stock outstanding on May 30, 2002. CUSIP No. 90136Q100 13G Page 3 of 5 Pages 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: Wallace J. Hillard ____________________________________________________________________ Item 2(b). Address of Principal Business Office, or if None, Residence: 2610 Bulrush Lane Naples, FL 34105 ____________________________________________________________________ Item 2(c). Citizenship: 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 Rule 13d-1(b), or 13d-2(b) or (c), Check Whether the Person Filing is a: Not applicable. CUSIP No. 90136Q100 13G Page 4 of 5 Pages Item 4. Ownership. Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount beneficially owned: 116,630 (1) ______________________________________________________________________ (b) Percent of class: 3.9% (2) ______________________________________________________________________ (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote 0 (ii) Shared power to vote or to direct the vote 116,630 (iii) Sole power to dispose or to direct the disposition of 0 (iv) Shared power to dispose or to direct the disposition of 116,630 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 [X]. _______________________________________________________________________ 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 or Control Person. 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. Certifications. Not applicable. - --------------------- 1 Represents 116,630 shares of Common Stock held by the Hilliard Flint Trust. 2 Calculated on the basis of 3,015,501 shares of Common Stock outstanding on May 30, 2002. 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: June 5, 2002 /s/ Daniel Hilliard, Trustee for Wallace J. Hilliard Flint Trust ------------------------------------------- Wallace J. Hilliard -----END PRIVACY-ENHANCED MESSAGE-----