SEC Form 4 · accession 0001209191-17-032079
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
Nov 30, 2016
Accepted (ET)
May 12, 2017 · 5:18 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 StockF1 | Nov 30, 2016 | J | 3,950,000 | — | D | 8,065,238 | D | |
| Common StockF2 | May 10, 2017 | J | 900,000 | — | D | 7,165,238 | D | |
| Common StockF3 | holding | — | — | — | 6,830,088 | I | By Corporation | |
| Common Stock | holding | — | — | — | 626,428 | I | By Steven M. Mariano Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On November 30, 2016, the Reporting Person transferred 3,950,000 shares of common stock that were previously held directly to a corporation controlled by the Reporting Person. The 3,950,000 shares were previously incorrectly reported on the Form 4 filed on January 10, 2017 as being held directly by the Reporting Person.
- F2On May 10, 2017, the Reporting Person transferred 900,000 shares of common stock that were previously held directly to a corporation controlled by the Reporting Person for value.
- F3Includes the 3,950,000 shares and 900,000 shares transferred from direct ownership to indirect ownership, as reported herein.