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