-----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, KDU8E1vgS76NmYhUhRDRpFIRSy5jEMoN6gbfvh1TKIPefj1U0s7Jydmkn/vRiDiH umDztFCjvfpCWxLOcUyyVg== 0000783603-07-000047.txt : 20070525 0000783603-07-000047.hdr.sgml : 20070525 20070525144918 ACCESSION NUMBER: 0000783603-07-000047 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070523 FILED AS OF DATE: 20070525 DATE AS OF CHANGE: 20070525 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: 07880292 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 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 mathis0525_ex.xml X0202 4 2007-05-23 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 2007-05-23 4 S 0 2600 21.41 D 1250 D Stock Options 13.67 2007-05-23 4 X 0 1689 21.41 D 2005-01-21 2014-01-21 Common Stock 1689 10000 D Stock Options 16.40 2007-05-23 4 X 0 911 21.41 D 2007-03-15 2016-03-15 Common Stock 911 9089 D Steven B. Mathis 2007-05-25 -----END PRIVACY-ENHANCED MESSAGE-----