-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, AWO3bvYaRl0IKm/Uu+k9FrUxQEL5IlK16DmN5/BcgdOyomCZoCMQpC+Ce+lkmpLo RIFgYh8ChwNdTWPtBIiZkQ== 0000783603-05-000025.txt : 20050131 0000783603-05-000025.hdr.sgml : 20050131 20050131155726 ACCESSION NUMBER: 0000783603-05-000025 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030130 FILED AS OF DATE: 20050131 DATE AS OF CHANGE: 20050131 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCOLLO JOSEPH D CENTRAL INDEX KEY: 0001244815 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 05561856 BUSINESS ADDRESS: BUSINESS PHONE: 441 295 5688 MAIL ADDRESS: STREET 1: 44 CHURCH STREET STREET 2: P O BOX HM2064 CITY: HAMILTON STATE: D0 ZIP: 99999 FORMER NAME: FORMER CONFORMED NAME: SCOLLO JOSEPH D JR DATE OF NAME CHANGE: 20030620 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN SAFETY INSURANCE HOLDINGS LTD CENTRAL INDEX KEY: 0000783603 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 44 CHURCH STREET CITY: HAMILTON STATE: D0 ZIP: HM HX BUSINESS PHONE: 4412968560 MAIL ADDRESS: STREET 1: 44 CHURCH STREET CITY: HAMILTON STATE: D0 ZIP: HM HX FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN SAFETY INSURANCE GROUP LTD DATE OF NAME CHANGE: 19971218 4 1 form4_ex.xml X0202 4 2003-01-30 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244815 SCOLLO JOSEPH D 3329 CRANMORE CHASE MARIETTA GA 30066 0 1 0 0 Executive Vice President Share Options (to buy) 6.75 2003-01-30 4 A 0 11000 6.75 D 2013-01-30 ASI 11000 50000 D Share Options (to buy) 8.57 2003-06-19 4 A 0 50000 8.57 D 2008-06-19 2013-06-19 ASI 50000 100000 D Share Options (to buy) 13.67 2004-01-22 4 A 0 12000 13.67 D 2014-01-22 ASI 12000 112000 D The Reporting Person was granted options to purchase Common Shares, which vest equally over three years beginning on the first anniversary of the date of grant Joseph D. Scollo, Jr. 2005-01-31 -----END PRIVACY-ENHANCED MESSAGE-----