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