SEC Form 4 · accession 0001209191-15-082650
Patriot National, Inc. · PN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Timothy J. Ermatinger
Officer — See Remarks
Period of report
Dec 1, 2015
Accepted (ET)
Dec 1, 2015 · 4:16 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 StockF1 | Dec 1, 2015 | S | 7,500 | $14.31 | D | 40,882 | D | |
| Common Stock | holding | — | — | — | 48,382 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF2 | $14.00 | holding | — | — | — | — | Jan 15, 2025 | Common Stock | 35,294 | 35,294 | D |
Explanation of responses
- F1The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $14.03 to $14.53, 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 numbers of shares purchased at each separate price within the range set forth in this footnote to this Form 4.
- F2The option vests in three equal annual installments beginning on January 15, 2016.
Remarks
President of Patriot Care Management, Inc.