0001140361-16-070557.txt : 20160622 0001140361-16-070557.hdr.sgml : 20160622 20160622141932 ACCESSION NUMBER: 0001140361-16-070557 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160620 FILED AS OF DATE: 20160622 DATE AS OF CHANGE: 20160622 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FEDERATED NATIONAL 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 BUSINESS ADDRESS: STREET 1: 14050 NW 14 STREET STREET 2: SUITE 180 CITY: SUNRISE STATE: FL ZIP: 33323 BUSINESS PHONE: 9545819993 MAIL ADDRESS: STREET 1: 14050 NW 14 STREET STREET 2: SUITE 180 CITY: SUNRISE STATE: FL ZIP: 33323 FORMER COMPANY: FORMER CONFORMED NAME: 21ST CENTURY HOLDING CO DATE OF NAME CHANGE: 19980909 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fernandez Erick Anthony CENTRAL INDEX KEY: 0001677866 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25001 FILM NUMBER: 161726431 MAIL ADDRESS: STREET 1: 1537 MANTUA AVENUE CITY: CORAL GABLES STATE: FL ZIP: 33146 3 1 doc1.xml FORM 3 X0206 3 2016-06-20 0 0001069996 FEDERATED NATIONAL HOLDING CO FNHC 0001677866 Fernandez Erick Anthony 14050 NW 14 STREET SUITE 180 SUNRISE FL 33323 0 1 0 0 Interim CFO Common Stock, par value $0.01 per share 3300 D A total of 3,300 of the Reporting Person's shares are subject to vesting under the Issuer's 2012 Stock Incentive Plan. /s/ Erick A. Fernandez 2016-06-22