SEC Form 4 · accession 0000899243-15-005850
Patriot National, Inc. · PN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Paul Halter
Officer — See Remarks
Period of report
Sep 14, 2015
Accepted (ET)
Oct 2, 2015 · 8:00 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001619917
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Sep 14, 2015 | A | 22,059 | $0.00 | A | 44,118 | D | |
| Common Stock | holding | — | — | — | 1,000 | I | By wife |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (right to buy)F2 | $16.17 | Sep 14, 2015 | A | 44,117 | A | — | Sep 14, 2025 | Common Stock | 44,117 | 88,234 | D |
Explanation of responses
- F1Award of restricted stock that vests in three equal annual installments beginning on September 14, 2016.
- F2The option vests in three equal annual installments beginning on September 14, 2016.
Remarks
Executive Vice President and National Director of Field Operations