0001140361-12-016011.txt : 20120315
0001140361-12-016011.hdr.sgml : 20120315
20120315172415
ACCESSION NUMBER: 0001140361-12-016011
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120315
FILED AS OF DATE: 20120315
DATE AS OF CHANGE: 20120315
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BRUEGGEN DAVID V
CENTRAL INDEX KEY: 0001244805
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-14795
FILM NUMBER: 12695045
MAIL ADDRESS:
STREET 1: BRUEGGEN DAVID V
STREET 2: 44 CHURCH ST
CITY: P O BOX HM2064
STATE: D0
ZIP: 99999
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
2012-03-15
0
0000783603
AMERICAN SAFETY INSURANCE HOLDINGS LTD
ASI
0001244805
BRUEGGEN DAVID V
BOYLE BUILDING, 2ND FLOOR
31 QUEEN STREET
HAMILTON
D0
HM 11
BERMUDA
1
0
0
0
Common Stock
2012-03-15
4
P
0
3000
18.21
A
30549
D
David V. Brueggen
2012-03-15