EDGAR Filing Documents for 0001209191-17-005599

Form 4 - Statement of changes in beneficial ownership of securities:

SEC Accession No. 0001209191-17-005599

Filing Date

2017-01-25

Accepted

2017-01-25 18:59:25

Documents

Period of Report

2017-01-01

Document Format Files

Seq	Description	Document	Type	Size
1	FORM 4 SUBMISSION	doc4.html	4
1	FORM 4 SUBMISSION	doc4.xml	4	3266
	Complete submission text file	0001209191-17-005599.txt		4705

Mailing Address 401 E. LAS OLAS BLVD. SUITE 1650 FORT LAUDERDALE FL 33301

Business Address 401 E. LAS OLAS BLVD. SUITE 1650 FORT LAUDERDALE FL 33301 (954) 670-2900

IRS No.: 464151376 | State of Incorp.: DE | Fiscal Year End: 1231
SIC: 6411 Insurance Agents, Brokers & Service

Mailing Address C/O PATRIOT NATIONAL, INC. 401 E. LAS OLAS BLVD., SUITE 1650 FORT LAUDERDALE FL 33301

Business Address

Type: 4 | Act: 34 | File No.: 001-36804 | Film No.: 17547591