0001140361-17-020097.txt : 20170512 0001140361-17-020097.hdr.sgml : 20170512 20170512160736 ACCESSION NUMBER: 0001140361-17-020097 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170512 FILED AS OF DATE: 20170512 DATE AS OF CHANGE: 20170512 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: Jordan Ronald Arthur CENTRAL INDEX KEY: 0001704133 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25001 FILM NUMBER: 17838621 MAIL ADDRESS: STREET 1: 5817 CRUTCHFIELD FARM RD CITY: OAK RIDGE STATE: NC ZIP: 27310 4 1 doc1.xml FORM 4 X0306 4 2017-05-12 0 0001069996 FEDERATED NATIONAL HOLDING CO FNHC 0001704133 Jordan Ronald Arthur 14050 N.W. 14 STREET SUITE 180 SUNRISE FL 33323 0 1 0 0 Chief Financial Officer Common Stock, par value $0.01 per share 2017-05-12 4 A 0 10000 A 10000 D Restricted stock award pursuant to the Issuer's 2012 Stock Incentive Plan granted in connection with the Reporting Person's employment with the Issuer. These shares are subject to vesting equally over five years. /s/ Ronald A. Jordan 2017-05-12