-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, QIeDWp0998C9Czym7n5wj1EV0AoHcEytISh3P6pjDNLWfdyn036iegxIvCqRY9Dq fXh9zRDUES2/Tt8WHhP0Qg== 0001140361-04-003003.txt : 20040511 0001140361-04-003003.hdr.sgml : 20040511 20040511153406 ACCESSION NUMBER: 0001140361-04-003003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040511 FILED AS OF DATE: 20040511 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: 04796311 BUSINESS ADDRESS: STREET 1: 7343 W PERSHING AVENUE CITY: PEORIA STATE: AZ ZIP: 85381 BUSINESS PHONE: 6233349783 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: 21ST CENTURY 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: 4161 N W 5TH STREET CITY: PLANTATION STATE: FL ZIP: 33317 BUSINESS PHONE: 9545819993 MAIL ADDRESS: STREET 1: 4161 N W 5TH STREET CITY: PLANTATION STATE: FL ZIP: 33317 4 1 doc1.xml FORM 4 X0202 4 2004-05-11 0 0001069996 21ST CENTURY HOLDING CO TCHC 0001186092 DORF CARL 4161 NW 5 STREET PLANTATION FL 33317 1 0 0 0 Common Stock 2004-05-11 4 S 0 100 20.151 D 600 I By Spouse & Child Common Stock 7000 I Joint Account w/Spouse Common Stock 9500 I Held by Dorf Partners 2001 LP Common Stock 39600 D Options 12.50 2003-06-04 2008-06-04 Common Stock 10000 10000 D The options vest 20% per year beginning June 4, 2003. /s/ Carl Dorf 2004-05-11 -----END PRIVACY-ENHANCED MESSAGE-----