0001140361-17-012328.txt : 20170316
0001140361-17-012328.hdr.sgml : 20170316
20170316160909
ACCESSION NUMBER: 0001140361-17-012328
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170314
FILED AS OF DATE: 20170316
DATE AS OF CHANGE: 20170316
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: 17694557
MAIL ADDRESS:
STREET 1: 7343 WEST PERSHING AVENUE
CITY: PEORIA
STATE: AZ
ZIP: 85387
4
1
doc1.xml
FORM 4
X0306
4
2017-03-14
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
2017-03-14
4
A
0
3289
A
30316
D
Common Stock, par value $0.01 per share
2017-03-14
4
S
0
2959
18.251
D
27357
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
Restricted stock award pursuant to the Issuer's 2012 Stock Incentive Plan.
1,047 restricted shares vested on 3/4/2017 and 1,912 restricted shares vested on 3/10/2017; therefore resulting from the vesting of 2,959 restricted shares and the grant of 3,289 restricted shares on 3/14/2017, a total of 12,419 of the Reporting Person's shares are subject to vesting under the Issuer's 2012 Stock Incentive Plan.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $18.25 to 18.27, 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.
The stock options are fully vested.
/s/ Carl Dorf
2017-03-16