SEC Form 4 · accession 0000899243-15-006388

Patriot National, Inc. · PN

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Steven M. Mariano

Officer — See Remarks · Director · 10% Owner

Period of report

Sep 30, 2015

Accepted (ET)

Oct 6, 2015 · 4:05 pm 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 30, 2015	P	460	$15.75	A	1,298,252	I	By Steven M. Mariano Trust
Common Stock^F2	Oct 1, 2015	P	9,146	$15.68	A	1,307,398	I	By Steven M. Mariano Trust
Common Stock	Oct 5, 2015	P	14,848	$15.00	A	14,566,175	D
Common Stock	holding	—	—		—	1,014,607	I	By Corporation

Table II — derivative securities

No Table II lines on this filing.

Explanation of responses

F1The purchase reported in this Form 4 was effected pursuant to a Rule 10b5-1 trading plan.
F2The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $15.50 to $15.75, inclusive. The reporting person undertakes to provide to Patriot National, Inc., any security holder of Patriot National, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in footnote 2 to this Form 4.

Remarks

President and Chief Executive Officer The Reporting Person disclaims beneficial ownership of the securities reported herein as indirectly beneficially owned, except to the extent of his pecuniary interest therein.