-----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, EsdqTJElI7r7mODJckI7o60uG5nyp7Q6tsGA0TxYGqemPIJphnwKcjARju8S5COz E13TcCch78fO9QQmvjtLIg== 0001140361-04-005857.txt : 20041022 0001140361-04-005857.hdr.sgml : 20041022 20041022155055 ACCESSION NUMBER: 0001140361-04-005857 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030603 FILED AS OF DATE: 20041022 DATE AS OF CHANGE: 20041022 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: 041091925 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 2003-06-03 0 0001069996 21ST CENTURY HOLDING CO TCHC 0001186092 DORF CARL 3661 WEST OAKLAND PARK BLVD., SUITE 300 LAUDERDALE LAKES FL 33311 1 0 0 0 Common Stock 2003-06-03 4 L 0 33.8983 12.39 A 6033.8983 I Held by Dorf Trust Common Stock 2003-09-03 4 L 0 35.2630 15.40 A 6069.1613 I Held by Dorf Trust Common Stock 2003-12-02 4 L 0 39.3338 15.43 A 6108.4951 I Held by Dorf Trust Common Stock 2004-08-18 4 S 0 286 19.9 D 8734.4951 I Held by Dorf Trust Common Stock 2004-08-18 4 S 0 500 19.91 D 7984.4951 I Held by Dorf Trust Common Stock 14250 I Held by Dorf Partners 2001 LP Common Stock 1500 I Held jointly with spouse Common Stock 900 I Held by Spouse's child Common Stock 59400 D Options 8.333 2003-06-04 2008-06-04 Common Stock 15000 15000 D Shares acquired through a dividend reinvestment option on the account, which shares were inadvertently omitted from the previously reported total. All share totals have been adjusted for the issuer's 3-for-2 stock split in September 2004. Shares owned with spouse that were subsequently transferred to an account controlled by the reporting person's spouse. Shares sold were sold due to margin call by broker. The reporting person disclaims beneficial ownership of these shares. Shares remaining jointly owned with spouse. The reporting person no longer has investment authority over this account and disclaims beneficial ownership of these shares. The options are fully vested. /s/ Carl Dorf 2004-10-22 -----END PRIVACY-ENHANCED MESSAGE-----