-----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, DmFIddLPmRXUR6Ci5+DMQe3/my+Z4TD/cQAe8xKhQu8x+3q1tJAgmwCqqIa7WFeF k8u7Z+/9S9G2pB/j0YgFsg== 0001140361-09-028255.txt : 20091207 0001140361-09-028255.hdr.sgml : 20091207 20091207145048 ACCESSION NUMBER: 0001140361-09-028255 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091204 FILED AS OF DATE: 20091207 DATE AS OF CHANGE: 20091207 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: 091225902 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 2009-12-04 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 2009-12-04 2009-12-04 4 S 0 100 15.20 D 18081 D Common Stock 2009-12-04 2009-12-04 4 S 0 2900 15.04 D 15181 D /s/ Frank D. Lackner 2009-12-07 -----END PRIVACY-ENHANCED MESSAGE-----