-----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, IOQq1C2LfsZ/OhuQLh3toClHurdAKEUZ5m9N79wsK/pmBDORH9YHghqzQMGVAx6+ 9M12ir7gcZk7euBd20iydg== 0001140361-09-029827.txt : 20091221 0001140361-09-029827.hdr.sgml : 20091221 20091221143237 ACCESSION NUMBER: 0001140361-09-029827 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091218 FILED AS OF DATE: 20091221 DATE AS OF CHANGE: 20091221 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: 091252153 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 2009-12-18 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 2009-12-18 2009-12-18 4 S 0 2000 14.33 D 12781 D /s/ Frank D. Lackner 2009-12-21 -----END PRIVACY-ENHANCED MESSAGE-----