SEC Form 4 · accession 0001209191-15-005090
Patriot National, Inc. · PN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas C Shields
Officer — See Remarks
Period of report
Jan 15, 2015
Accepted (ET)
Jan 20, 2015 · 4:30 pm EST
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 | Jan 15, 2015 | A | 70,588 | $0.00 | A | 70,588 | D |
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 | $14.00 | Jan 15, 2015 | A | 141,176 | A | — | Jan 15, 2025 | Common Stock | 141,176 | 141,176 | D |
Explanation of responses
- F1Award of restricted stock that vests in three equal annual installments beginning on January 15, 2016.
- F2The option vests in three equal annual installments beginning on January 15, 2016.
Remarks
Executive Vice President, Chief Financial Officer and Treasurer