-----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, RbOpPuagD99xJx58GDYyFWS5oAYeAt2WTNaUGnaYA3xFY4v5XiZn6bdM7pAXyCKM Hs/WQyE4AATVv2c8QpgEnw== 0001140361-04-006979.txt : 20041215 0001140361-04-006979.hdr.sgml : 20041215 20041215164643 ACCESSION NUMBER: 0001140361-04-006979 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040506 FILED AS OF DATE: 20041215 DATE AS OF CHANGE: 20041215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jennings James Gordon III CENTRAL INDEX KEY: 0001311501 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25001 FILM NUMBER: 041205326 BUSINESS ADDRESS: BUSINESS PHONE: 954-308-1201 MAIL ADDRESS: STREET 1: P.O. BOX 407193 CITY: FORT LAUDERDALE STATE: FL ZIP: 33340 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 2004-05-06 0 0001069996 21ST CENTURY HOLDING CO TCHC 0001311501 Jennings James Gordon III 3661 WEST OAKLAND PARK BLVD. SUITE 300 LAUDERDALE LAKES FL 33311 0 1 0 0 CFO Common Stock 2004-12-13 4 S 0 15000 13.1003 D 0 D Common Stock 2004-12-14 4 S 0 1000 13.05 D 0 D Options 20.00 2004-05-06 4 A 0 30000 20.00 A 2005-05-06 2010-05-06 Common Stock 30000 30000 D Options 6.667 2004-12-13 4 X 0 15000 6.667 D 2003-01-02 2012-01-02 Common Stock 15000 15000 D Options 9.167 2004-12-14 4 X 0 1000 9.167 D 2003-06-04 2008-06-04 Common Stock 1000 14000 D All share totals, option totals and options prices have been adjusted for the issuers 3-for-2 stock split in September 2004. Options vest 20% per year beginning on 05/06/2005. Options granted were inadvertently not reported due to error. Options vest 25% per year beginning 01/02/2003. Options vest 20% per year beginning on 06/04/2003. /s/ James Gordon Jennings, III 2004-12-15 -----END PRIVACY-ENHANCED MESSAGE-----