-----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, PmkGArfAXDahAoWcY/T0ExxRIzllpjP8Iqs7GEiUqkEWh9fuQBaPt/H0QcHPzbYP TZQZ1IwpgsrFwIoK4G2upA== 0000783603-06-000033.txt : 20060621 0000783603-06-000033.hdr.sgml : 20060621 20060621145749 ACCESSION NUMBER: 0000783603-06-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20060621 FILED AS OF DATE: 20060621 DATE AS OF CHANGE: 20060621 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lackner Frank D CENTRAL INDEX KEY: 0001315632 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 06917246 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: HM HX 4 1 lackner_ex.xml X0202 4 2006-06-21 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001315632 Lackner Frank D 237 LAFAYETTE STREET APT. 9E NEW YORK NY 100212 1 0 0 0 Common Shares 2006-06-20 2006-06-20 4 P 0 5000 15.50 A 8542 D Frank D. Lackner By Power of Attorney 2006-06-21 -----END PRIVACY-ENHANCED MESSAGE-----