-----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, RjFtFHko1jSAsBfgF6vmYrog/hH9w0tSh0nC+dZetax7YvC6hC2yK/wjv8r4/o3k YaM63w/jpHDwy5MKxS5sDw== 0000783603-08-000095.txt : 20080818 0000783603-08-000095.hdr.sgml : 20080818 20080818131248 ACCESSION NUMBER: 0000783603-08-000095 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20080814 FILED AS OF DATE: 20080818 DATE AS OF CHANGE: 20080818 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: 31 QUEENS STREET STREET 2: 2ND FLOOR CITY: HAMILTON STATE: D0 ZIP: HM 11 BUSINESS PHONE: 441-296-8560 MAIL ADDRESS: STREET 1: 31 QUEENS STREET STREET 2: 2ND FLOOR CITY: HAMILTON STATE: D0 ZIP: HM 11 FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN SAFETY INSURANCE GROUP LTD DATE OF NAME CHANGE: 19971218 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BRUEGGEN DAVID V CENTRAL INDEX KEY: 0001244805 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 081024561 MAIL ADDRESS: STREET 1: BRUEGGEN DAVID V STREET 2: 44 CHURCH ST CITY: P O BOX HM2064 STATE: D0 ZIP: 99999 4 1 form4brueggen081508_ex.xml X0303 4 2008-08-14 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244805 BRUEGGEN DAVID V BRUEGGEN DAVID V 44 CHURCH ST P O BOX HM2064 D0 99999 BERMUDA 1 0 0 0 Common Stock 2008-07-31 2008-08-14 4 D 0 1608 0.00 D 295040 I Shares granted on 7/31/08 were erroneously granted to Anning-Johnson instead of D. Brueggen directly Common Stock 2008-08-14 2008-08-14 4 A 0 1608 21.77 A 14008 D Common Stock 2008-08-14 2008-08-14 4 P 0 1400 16.25 A 12400 D On 7/31/2008, 1,608 shares erroneously granted to Anning-Johnson Company instead of D. Brueggen directly. Corrected certificate was requested on 8/14. David V. Brueggen 2008-08-14 -----END PRIVACY-ENHANCED MESSAGE-----