0001140361-14-035336.txt : 20140911 0001140361-14-035336.hdr.sgml : 20140911 20140911160442 ACCESSION NUMBER: 0001140361-14-035336 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140909 FILED AS OF DATE: 20140911 DATE AS OF CHANGE: 20140911 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FEDERATED NATIONAL 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: 14050 NW 14 STREET STREET 2: SUITE 180 CITY: SUNRISE STATE: FL ZIP: 33323 BUSINESS PHONE: 9545819993 MAIL ADDRESS: STREET 1: 14050 NW 14 STREET STREET 2: SUITE 180 CITY: SUNRISE STATE: FL ZIP: 33323 FORMER COMPANY: FORMER CONFORMED NAME: 21ST CENTURY HOLDING CO DATE OF NAME CHANGE: 19980909 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: 141098237 MAIL ADDRESS: STREET 1: 7343 WEST PERSHING AVENUE CITY: PEORIA STATE: AZ ZIP: 85387 4 1 doc1.xml FORM 4 X0306 4 2014-09-09 0 0001069996 FEDERATED NATIONAL HOLDING CO FNHC 0001186092 DORF CARL 14050 N.W. 14 STREET SUITE 180 SUNRISE FL 33323 1 0 0 0 Common Stock, par value $0.01 per share 2014-09-09 4 A 0 10000 A 23142 D Common Stock, par value $0.01 per share 63491 I Held by Dorf Trust Common Stock, par value $0.01 per share 59624 I Held by Carl Dorf Rollover IRA Stock Options (right to buy) 2.45 2012-08-22 2021-08-22 Common Stock, par value $0.01 per share 10000 10000 D Stock Options (right to buy) 4.40 2013-04-06 2022-04-06 Common Stock, par value $0.01 per share 15000 15000 D Restricted stock award pursuant to the Issuer's 2012 Stock Incentive Plan. A total of 15,808 of the Reporting Person's shares are subject to vesting under the Issuer's 2012 Stock Incentive Plan. Stock options vest 33 1/3% per year. /s/ Carl Dorf 2014-09-11