0001140361-16-079815.txt : 20160914 0001140361-16-079815.hdr.sgml : 20160914 20160914164019 ACCESSION NUMBER: 0001140361-16-079815 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160913 FILED AS OF DATE: 20160914 DATE AS OF CHANGE: 20160914 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: DORF CARL CENTRAL INDEX KEY: 0001186092 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25001 FILM NUMBER: 161885453 MAIL ADDRESS: STREET 1: 7343 WEST PERSHING AVENUE CITY: PEORIA STATE: AZ ZIP: 85387 4 1 doc1.xml FORM 4 X0306 4 2016-09-13 0 0001069996 FEDERATED NATIONAL HOLDING CO FNHC 0001186092 DORF CARL 14050 N.W. 14 STREET SUITE 180 SUNRISE FL 33323 1 0 0 0 Common Stock, par value $0.01 per share 2016-09-13 4 S 0 655 17.82 D 27027 D Common Stock, par value $0.01 per share 63491 I Held by Dorf Trust Common Stock, par value $0.01 per share 59624 I Held by Carl Dorf Rollover IRA Stock Options (right to buy) 2.45 2012-08-22 2021-08-22 Common Stock, par value $0.01 per share 10000 10000 D Stock Options (right to buy) 4.40 2013-04-06 2022-04-06 Common Stock, par value $0.01 per share 15000 15000 D The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $17.811 to 17.84, inclusive. The Reporting Person undertakes to provide to the Issuer, any security holding of the Issuer, or the staff of the SEC, upon request, full information regarding the number of share sold at each separate price with the range set forth above. 2,000 restricted shares vested on 9/9/2016; therefore resulting from the vesting of 2,000 restricted shares, a total of 12,089 of the Reporting Person's shares are subject to vesting under the Issuer's 2012 Stock Incentive Plan. The stock options are fully vested. /s/ Carl Dorf 2016-09-14