SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
Patel Paresh

(Last) (First) (Middle)
C/O OXBRIDGE RE HOLDINGS LIMITED
903 S. CHURCH ST., P.O. BOX 469

(Street)
GRAND CAYMAN E9 KY1-9006

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
OXBRIDGE RE HOLDINGS Ltd [ OXBRU ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2015
4. If Amendment, Date of Original Filed (Month/Day/Year)
02/16/2016
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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Ordinary Shares 12/31/2015 J(1) 74,985 A $0(1) 130,000 I See Footnote(2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants to Purchase Ordinary Shares $7.5 12/31/2015 J 151,123 (3) 03/31/2019 Ordinary Shares 151,123 (1) 262,000 I See Footnote(2)
Explanation of Responses:
1. On December 31, 2015, the reporting person bought out the other members of Dharma Partners, LLC, which is the 100% owner of Moksha Capital Partners Re (P) Ltd., which is the owner of 130,000 ordinary shares of the issuer and 262,000 warrants to purchase ordinary shares. As a result of the buyout, reporting person indirectly acquired beneficial ownership of all 130,000 ordinary shares and 262,000 warrants held by Moksha Capital Partners Re (P) Ltd., an increase of 74,985 in the number of ordinary shares and an increase of 151,123 in the number of warrants, respectively, previously reported as being held by the reporting person prior to the buyout.
2. Shares are held by Moksha Capital Partners Re (P) Ltd., which is 100% owned by Dharma Partners, LLC. Reporting person is 100% owner of Dharma Partners, LLC.
3. Immediately exercisable.
Remarks:
/s/ Curt P. Creely, Attorney-in-Fact for Paresh Patel 02/17/2016
** 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 4 (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).
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