SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
MARTIN ALLAN S.

(Last) (First) (Middle)
101 EAST KENNEDY BOULEVARD,
SUITE 4110

(Street)
TAMPA FL 33602

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/20/2023
3. Issuer Name and Ticker or Trading Symbol
OXBRIDGE RE HOLDINGS Ltd [ OXBR ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Ordinary Shares 213,853(1) D
Ordinary Shares 83,000(2) I See footnote(2)
Ordinary Shares 70(3) I See footnote(3)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants to Purchase Ordinary Shares 03/26/2014 03/26/2024 Ordinary Shares 259,258(1)(4) $7.5 D
Warrants to Purchase Ordinary Shares 03/26/2014 03/26/2024 Ordinary Shares 249,000(2)(4) $7.5 I See footnote(2)
Warrants to Purchase Ordinary Shares 03/26/2014 03/26/2024 Ordinary Shares 39,000(3)(4) $7.5 I See footnote(3)
Explanation of Responses:
1. Ordinary Shares and Warrants held by Allan S. Martin and his wife, Marie B. Martin, jointly.
2. Ordinary Shares and Warrants indirectly held in the name of Fleur de Lis Partners, LLLP. As the general partner of Fleur de Lis Partners, LLLP, Mr. Martin has voting and investment power over the ordinary shares and warrants held by that entity. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of the reporting person's pecuniary interest in such securities.
3. Ordinary Shares and Warrants indirectly held in the name of the Martin Family Foundation, Inc. As one of the directors of the Foundation, Inc. Mr. Martin has shared voting and shared investment power over the ordinary shares and warrants held by that entity. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose, except to the extent of the reporting person's pecuniary interest in such securities.
4. On November 16, 2018, the Warrants issued as part of the units in the Company's April 2014 initial public offering, expiration date were extended until March 26, 2024.
/s/Gregory Yadley as Attorney-in-Fact for Reporting Person 07/31/2023
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.