0001140361-12-024156.txt : 20120510 0001140361-12-024156.hdr.sgml : 20120510 20120510102831 ACCESSION NUMBER: 0001140361-12-024156 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120509 FILED AS OF DATE: 20120510 DATE AS OF CHANGE: 20120510 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCOLLO JOSEPH D CENTRAL INDEX KEY: 0001244815 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 12828204 MAIL ADDRESS: STREET 1: 44 CHURCH STREET STREET 2: P O BOX HM2064 CITY: HAMILTON STATE: D0 ZIP: 99999 FORMER NAME: FORMER CONFORMED NAME: SCOLLO JOSEPH D JR DATE OF NAME CHANGE: 20030620 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 X0305 4 2012-05-09 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244815 SCOLLO JOSEPH D BOYLE BUIDLING, 2ND FLOOR 31 QUEEN STREET HAMILTON D0 HM 11 BERMUDA 0 1 0 0 COO Common Stock 2012-05-09 4 S 0 2250 18.41 D 146654 D Joseph D. Scollo, Jr. 2012-05-09