0000899243-16-012316.txt : 20160128 0000899243-16-012316.hdr.sgml : 20160128 20160128170612 ACCESSION NUMBER: 0000899243-16-012316 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20160122 FILED AS OF DATE: 20160128 DATE AS OF CHANGE: 20160128 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Patriot National, Inc. CENTRAL INDEX KEY: 0001619917 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 464151376 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 401 E. LAS OLAS BLVD. STREET 2: SUITE 1650 CITY: FORT LAUDERDALE STATE: FL ZIP: 33301 BUSINESS PHONE: (954) 670-2900 MAIL ADDRESS: STREET 1: 401 E. LAS OLAS BLVD. STREET 2: SUITE 1650 CITY: FORT LAUDERDALE STATE: FL ZIP: 33301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Corey Michael J. CENTRAL INDEX KEY: 0001665153 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36804 FILM NUMBER: 161369830 MAIL ADDRESS: STREET 1: C/O PATRIOT NATIONAL, INC. STREET 2: 401 E. LAS OLAS BLVD., SUITE 1650 CITY: FORT LAUDERDALE STATE: FL ZIP: 33301 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2016-01-22 1 0001619917 Patriot National, Inc. PN 0001665153 Corey Michael J. C/O PATRIOT NATIONAL, INC. 401 EAST LAS OLAS BOULEVARD, SUITE 1650 FORT LAUDERDALE FL 33301 1 0 0 0 Exhibit 24 - Power of Attorney By: /s/ Christopher A. Pesch, by power of attorney 2016-01-28 EX-24 2 attachment1.htm EX-24 DOCUMENT

                               POWER OF ATTORNEY

      Know all by these presents that Michael J.  Corey, does hereby make,
constitute and appoint each of Christopher A. Pesch and Christopher L. Pizzo, or
any one of them, as a true and lawful attorney-in- fact of the undersigned with
full powers of substitution and revocation, for and in the name, place and stead
of the undersigned (in the undersigned's individual capacity), to execute and
deliver such forms that the undersigned may be required to file with the U.S.
Securities and Exchange Commission as a result of the undersigned's ownership of
or transactions in securities of Patriot National, Inc. (i) pursuant to Section
16(a) of the Securities Exchange Act of 1934, as amended, including without
limitation, statements on Form 3, Form 4 and Form 5 (including any amendments
thereto) and (ii) in connection with any applications for EDGAR access codes,
including without limitation the Form ID.

      The Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with regard to his
ownership of or transactions in securities of Patriot National, Inc., unless
earlier revoked in writing. The undersigned acknowledges that Christopher A.
Pesch and Christopher L. Pizzo are not assuming any of the undersigned's
responsibilities to comply with Section 16 of the Securities Exchange Act of
1934.


                                           By:   /s/ Michael J. Corey
                                                 --------------------
                                           Name:     Michael J. Corey
                                           Date:     January 25, 2016