-----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, C4m+o00xrmdT0Cqmbh4yC6va5FhGYYVioQqNh4E6OAdFh/XIm7pIiIFwpv+YAj38 s8VUWj4iv2pWIjM9jv783w== 0000783603-09-000015.txt : 20090306 0000783603-09-000015.hdr.sgml : 20090306 20090306141008 ACCESSION NUMBER: 0000783603-09-000015 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090306 FILED AS OF DATE: 20090306 DATE AS OF CHANGE: 20090306 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCOLLO JOSEPH D CENTRAL INDEX KEY: 0001244815 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 09662048 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: 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 4/A 1 scolloform4a20090202_ex.xml X0303 4/A 2009-03-06 2009-02-02 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244815 SCOLLO JOSEPH D 44 CHURCH STREET P O BOX HM2064 HAMILTON D0 99999 BERMUDA 0 1 0 0 Exec. VP/COO Stock Options (right to buy) 9.50 2009-02-02 2009-02-02 4 A 0 10000 9.50 D 2000-02-12 2009-02-12 Common Stock 10000 132540 D Total listed as 11,379 on original filing should be 132,540. Joseph D. Scollo, Jr. 2009-03-06 -----END PRIVACY-ENHANCED MESSAGE-----