SEC Form 4 · accession 0001209191-17-048310
Patriot National, Inc. · PN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Todd E. Wilson
Officer — Executive Vice President
Period of report
Aug 9, 2017
Accepted (ET)
Aug 9, 2017 · 5:26 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, par value $0.001 per share | Aug 9, 2017 | A | 250,000 | $0.00 | A | 281,337 | 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 Options (right to buy)F2 | $16.67 | holding | — | — | — | — | Jun 1, 2025 | Common Stock | 46,512 | 46,512 | D |
Explanation of responses
- F1Award of restricted stock that vests in full on January 1, 2018.
- F2The options vest in three equal annual installments beginning on June 1, 2016.