0001140361-11-038718.txt : 20110801 0001140361-11-038718.hdr.sgml : 20110801 20110801150836 ACCESSION NUMBER: 0001140361-11-038718 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110801 FILED AS OF DATE: 20110801 DATE AS OF CHANGE: 20110801 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GROOT STEVEN L CENTRAL INDEX KEY: 0001201022 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 111000320 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 X0304 4 2011-08-01 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001201022 GROOT STEVEN L 44 CHURCH STREET P.O. BOX HM2064 HAMILTON D0 HM HX BERMUDA 1 0 0 0 Common Stock 2011-07-29 2011-07-29 4 A 0 2934 18.75 A 46086 I Shares owned by the Steven L. Groot Living Trust Shares issued under the Director Compensation Policy. Per the policy, shares will be held in escrow until the 2012 Shareholders meeting. Steven L. Groot 2011-08-01