-----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, P1LX7EFfVe+xkVc9Ktpvfi5J+Khf7lgW/VYXIqUR0FaBNNVZgE6DOK79TkWLuSWh eu19hoKEU3C2JG4POws2YA== 0000783603-07-000041.txt : 20070516 0000783603-07-000041.hdr.sgml : 20070516 20070516145438 ACCESSION NUMBER: 0000783603-07-000041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070514 FILED AS OF DATE: 20070516 DATE AS OF CHANGE: 20070516 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: MATHIS STEVEN B CENTRAL INDEX KEY: 0001244809 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 07857431 BUSINESS ADDRESS: BUSINESS PHONE: 441 295 5688 MAIL ADDRESS: STREET 1: 44 CHURCH ST STREET 2: P O BOX HM2064 CITY: HAMILTON STATE: D0 ZIP: 99999 4 1 mathis_ex.xml X0202 4 2007-05-14 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244809 MATHIS STEVEN B 1801 URQUART MARIETTA GA 30068 0 0 0 1 Former Treasurer Common Stock 2007-05-14 4 S 0 1800 21.39 D 1250 D Common Stock 2007-05-15 4 S 0 14851 21.40 D 1250 D Stock Options 6.00 2007-05-14 4 X 0 1800 21.39 D 2001-06-23 2010-06-23 Common Stock 1800 69200 D Stock Options 6.00 2007-05-15 4 X 0 5200 21.40 D 2001-06-23 2010-06-23 Common Stock 5200 64000 D Stock Options 6.75 2007-05-15 4 X 0 8000 21.40 D 2004-01-30 2013-01-30 Common Stock 8000 56000 D Stock Options 8.57 2007-05-15 4 X 0 1651 21.40 D 2004-06-19 2013-06-19 Common Stock 1651 54349 D Steven B. Mathis 2007-05-17 -----END PRIVACY-ENHANCED MESSAGE-----