0001140361-16-070557.txt : 20160622
0001140361-16-070557.hdr.sgml : 20160622
20160622141932
ACCESSION NUMBER: 0001140361-16-070557
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160620
FILED AS OF DATE: 20160622
DATE AS OF CHANGE: 20160622
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: Fernandez Erick Anthony
CENTRAL INDEX KEY: 0001677866
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-25001
FILM NUMBER: 161726431
MAIL ADDRESS:
STREET 1: 1537 MANTUA AVENUE
CITY: CORAL GABLES
STATE: FL
ZIP: 33146
3
1
doc1.xml
FORM 3
X0206
3
2016-06-20
0
0001069996
FEDERATED NATIONAL HOLDING CO
FNHC
0001677866
Fernandez Erick Anthony
14050 NW 14 STREET
SUITE 180
SUNRISE
FL
33323
0
1
0
0
Interim CFO
Common Stock, par value $0.01 per share
3300
D
A total of 3,300 of the Reporting Person's shares are subject to vesting under the Issuer's 2012 Stock Incentive Plan.
/s/ Erick A. Fernandez
2016-06-22