0001140361-13-002211.txt : 20130116 0001140361-13-002211.hdr.sgml : 20130116 20130116113712 ACCESSION NUMBER: 0001140361-13-002211 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130115 FILED AS OF DATE: 20130116 DATE AS OF CHANGE: 20130116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CRIM STEPHEN R CENTRAL INDEX KEY: 0001244806 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 13531888 MAIL ADDRESS: STREET 1: 44 CHURCH ST STREET 2: P O BOX HM2064 CITY: HAMILTON 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 X0306 4 2013-01-15 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244806 CRIM STEPHEN R BOYLE BUILDING, 2ND FLOOR 31 QUEEN STREET HAMILTON D0 HM 11 BERMUDA 1 1 0 0 CEO COMMON STOCK 2013-01-15 4 M 0 12000 6.75 A 266951 D COMMON STOCK 38995 I Shares owned by spouse. COMMON STOCK 1569 I Shares held as custodian for children. STOCK OPTIONS 6.75 2013-01-15 4 M 0 12000 6.75 D 2008-01-30 2013-01-30 COMMON STOCK 12000 188616 D Stephen R. Crim 2013-01-15