Sec Form 4 Filing - Mariano Steven M. @ Patriot National, Inc. - 2015-12-23

FORM 4 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person Mariano Steven M. 2. Issuer Name and Ticker or Trading Symbol Patriot National, Inc. [ PN] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X __ Director X __ 10% Owner X __ Officer (give title below) _____ Other (specify below) See Remarks (Last) (First) (Middle) C/O PATRIOT NATIONAL, INC., 401 E. LAS OLAS BLVD., SUITE 1650 3. Date of Earliest Transaction (MM/DD/YY) 12/23/2015 (Street) FORT LAUDERDALE, FL33301 4. If Amendment, Date Original Filed (MM/DD/YY) 6. Individual or Joint/Group Filing (Check Applicable Line) __ X __ Form filed by One Reporting Person _____ Form filed by More than One Reporting Person (City) (State) (Zip)

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1.Title of Security (Instr. 3) 2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4) Code V Amount (A) or (D) Price

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities) 1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) 6. Date Exercisable and Expiration Date (MM/DD/YY) 7. Title and Amount of Underlying Securities (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4) Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares Obligation to Sell ( 1 ) ( 2 ) ( 1 ) ( 2 ) 12/23/2015 A( 1 )( 3 )( 4 )( 5 ) 1,250,000 ( 1 ) ( 3 ) ( 4 ) ( 5 ) ( 2 ) ( 2 ) Common Stock 1,250,000 ( 1 ) ( 4 ) ( 1 ) ( 3 ) ( 4 ) ( 5 ) 0 D Obligation to Sell ( 5 ) ( 6 ) ( 5 ) ( 6 ) 12/23/2015 D( 1 )( 3 )( 4 )( 5 ) 3,250,000 ( 3 ) ( 5 ) ( 6 ) ( 6 ) Common Stock 3,250,000 ( 3 ) ( 5 ) ( 1 ) ( 3 ) ( 4 ) ( 5 ) 3,250,000 ( 3 ) ( 5 ) D

Reporting Owners Reporting Owner Name / Address Relationships Director 10% Owner Officer Other Mariano Steven M. C/O PATRIOT NATIONAL, INC. 401 E. LAS OLAS BLVD., SUITE 1650 FORT LAUDERDALE, FL33301 X X See Remarks Signatures /s/ Christopher A. Pesch, by power of attorney 12/28/2015 Signature of Reporting Person Date

Explanation of Responses:

( 1 )On December 13, 2015, the Issuer and the Reporting Person entered into an agreement (the "Stock Back-to-Back Agreement") pursuant to which the Issuer would repurchase a number of shares of Common Stock owned by the Reporting Person equal to 60% of the shares of Common Stock to be issued by the Issuer to the Purchasers in connection with the exercise by Purchasers of the Old Warrants. ( 2 )This obligation to sell under the Stock Back-to-Back Agreement related to the Old Series A Warrants. The Old Series A Warrants were exercisable at the lower of $15 per share or a variable exercise price described therein. The Old Series A Warrants were exercisable beginning on July 1, 2016 and were to expire on June 30, 2018. ( 3 )On December 23, 2015, the Issuer and Reporting Person entered into Rescission and Exchange Agreements with the Purchasers (the "Rescission and Exchange Agreements"), pursuant to which, among other things, the Issuer and each Purchaser agreed to exchange the Old Series A Warrants for new Series A Warrants exercisable for an aggregate of 3,250,000 shares of Common Stock (the "New Series A Warrants") and Old Series B Warrants for new Series B Warrants exercisable for an aggregate of 1,000,000 shares of Common Stock, subject to adjustments pursuant to the terms therein (the "New Series B Warrants", and together with the New Series A Warrants, the "New Warrants"). ( 4 )On December 13, 2015, the Issuer, Reporting Person and certain purchasers identified therein (the "Purchasers") entered into a Securities Purchase Agreement (the "Purchase Agreement"), pursuant to which the Reporting Person sold to the Purchasers an aggregate of 2,500,000 shares of issuer common stock ("Common Stock") for an aggregate purchase price of $30 million. Additionally, pursuant to the Purchase Agreement, the Issuer issued and sold to the Purchasers (i) 666,666 shares of Common Stock and prepaid Series B warrants for 1,000,000 shares of Common Stock, subject to adjustments pursuant to the terms therein (the "Old Series B Warrants"), and (ii) Series A warrants to purchase up to an aggregate of 2,083,333 shares of Common Stock (the " Old Series A Warrants", and together with the Old Series B Warrants, the "Old Warrants"), for an aggregate purchase price of approximately $20 million. The transaction described herein (the "Transaction") closed on December 16, 2015. ( 5 )Additionally, on December 23, 2015, the Issuer and Reporting Persons entered into an Amended and Restated Stock Back-to-Back Agreement (the "Amended Back-to-Back Agreement"), pursuant to which the Issuer would repurchase a number of shares of Common Stock owned by the Reporting Person equal to 100% of the shares of Common Stock to be issued by the Issuer to the Purchasers in connection with the exercise by Purchasers of the New Warrants. The transactions described in this footnote closed on December 23, 2015. ( 6 )This obligation to sell under the Amended Back-to-Back Agreement relates to the New Series A Warrants. The New Series A Warrants are exercisable at the lower of $10 per share or a variable exercise price described therein. The New Series A Warrants are exercisable beginning on July 1, 2016 and expire on December 31, 2020.

Remarks: President and Chief Executive OfficerThe Reporting Person disclaims beneficial ownership of the securities reported herein as indirectly beneficially owned, except to the extent of his pecuniary interest therein. The filing of this Form 4 shall not be deemed to be an admission that the Reporting Person is the beneficial owner of any of the securities reported herein for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4(b)(v).

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