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