0001144204-13-020806.txt : 20130409
0001144204-13-020806.hdr.sgml : 20130409
20130409144453
ACCESSION NUMBER: 0001144204-13-020806
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130409
FILED AS OF DATE: 20130409
DATE AS OF CHANGE: 20130409
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LOW NATHAN A
CENTRAL INDEX KEY: 0001013313
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-54897
FILM NUMBER: 13750814
MAIL ADDRESS:
STREET 1: 641 LEXINGTON AVE
STREET 2: C/O SUNRISE SECURITIES
CITY: NEW YORK
STATE: NY
ZIP: 10022
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Fern Holdings Corp.
CENTRAL INDEX KEY: 0001567517
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 301749642
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0331
BUSINESS ADDRESS:
STREET 1: C/O SAMIR MASRI CPA FIRM P.C.
STREET 2: 175 GREAT NECK ROAD, SUITE 403
CITY: GREAT NECK
STATE: NY
ZIP: 11021
BUSINESS PHONE: 516-466-6193
MAIL ADDRESS:
STREET 1: C/O SAMIR MASRI CPA FIRM P.C.
STREET 2: 175 GREAT NECK ROAD, SUITE 403
CITY: GREAT NECK
STATE: NY
ZIP: 11021
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NLBDIT 2010 SERVICES, LLC
CENTRAL INDEX KEY: 0001531172
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-54897
FILM NUMBER: 13750816
BUSINESS ADDRESS:
STREET 1: C/O SUNRISE SECURITIES CORP
STREET 2: 641 LEXINGTON AVENUE, 25TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 212 421 1616
MAIL ADDRESS:
STREET 1: C/O SUNRISE SECURITIES CORP
STREET 2: 641 LEXINGTON AVENUE, 25TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NATHAN LOW 2008 IRREVOCABLE TRUST
CENTRAL INDEX KEY: 0001531173
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-54897
FILM NUMBER: 13750815
BUSINESS ADDRESS:
STREET 1: C/O SUNRISE SECURITIES CORP
STREET 2: 641 LEXINGTON AVENUE, 25TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 212 421 1616
MAIL ADDRESS:
STREET 1: C/O SUNRISE SECURITIES CORP
STREET 2: 641 LEXINGTON AVENUE, 25TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
3
1
v340837_3.xml
OWNERSHIP DOCUMENT
X0206
3
2013-04-09
0
0001567517
Fern Holdings Corp.
NONE
0001531172
NLBDIT 2010 SERVICES, LLC
C/O SUNRISE SECURITIES CORP.
600 LEXINGTON AVENUE, 23RD FLOOR
NEW YORK
NY
10022
0
0
1
0
0001531173
NATHAN LOW 2008 IRREVOCABLE TRUST
C/O SUNRISE SECURITIES CORP.
600 LEXINGTON AVENUE, 23RD FLOOR
NEW YORK
NY
10022
0
0
1
0
0001013313
LOW NATHAN A
C/O SUNRISE SECURITIES CORP.
600 LEXINGTON AVENUE, 23RD FLOOR
NEW YORK
NY
10022
0
0
1
0
Common Stock, par value $.0001 per share(the "Common Stock")
5000000
D
Common Stock
5000000
I
See Footnote
Common Stock
5000000
I
See Footnote
Represents the shares of Common Stock owned of record by NLBDIT 2010 Services, LLC. ("NLBDIT Services") and beneficially by The Nathan Low 2008 Irrevocable Trust ("Low Trust"). The Low Trust owns 100% of the outstanding membership interests of NLBDIT Services and may be deemed to beneficially own the shares of Common Stock held of record by NLBDIT Services.
Represents the shares of Common Stock owned of record by NLBDIT Services and beneficially by Nathan A. Low. Mr. Low is the family trustee of the Low Trust and has voting and dispositive control over any securities owned of record or beneficially by the Low Trust. Therefore, Mr. Low may be deemed to beneficially own the shares of Common Stock held by NLBDIT Services.
/s/ Nathan A. Low, Family Trustee of Sole Member
2013-04-09
/s/ Nathan A. Low, Family Trustee
2013-04-09
/s/ Nathan A. Low
2013-04-09