-----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, NNlTEIk0QfiTSzcLbIxVjCZkhz/ZhP2Pdy1o00idrKYGm/i1HAS9TzW0HeySlGNq SFtY8DNFhh8b89u3QSDbhA== 0001140361-09-027028.txt : 20091120 0001140361-09-027028.hdr.sgml : 20091120 20091120171345 ACCESSION NUMBER: 0001140361-09-027028 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091120 FILED AS OF DATE: 20091120 DATE AS OF CHANGE: 20091120 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: 091199513 MAIL ADDRESS: STREET 1: 44 CHURCH STREET STREET 2: P.O. BOX HM2064 CITY: HAMILTON STATE: D0 ZIP: HM HX 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 1 doc1.xml FORM 4 X0303 4 2009-11-20 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001315632 Lackner Frank D 44 CHURCH STREET P.O. BOX HM2064 HAMILTON D0 HM HX BERMUDA 1 0 0 0 Common Stock 2009-11-20 2009-11-20 4 S 0 1964 14.42 D 18717 D Common Stock 2009-11-20 2009-11-20 4 S 0 100 14.48 D 18617 D Common Stock 2009-11-20 2009-11-20 4 S 0 436 14.51 D 18181 D /s/ Frank D. Lackner 2009-11-20 -----END PRIVACY-ENHANCED MESSAGE-----