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*
PATEL MAYUR

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

(Street)
GRAND CAYMAN E9 KY1-9006

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/26/2014
3. Issuer Name and Ticker or Trading Symbol
OXBRIDGE RE HOLDINGS Ltd [ OXBRU ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 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, Par Value $0.001 83,000 D
Ordinary Shares, Par Value $0.001 6,223 I See Footnote(1)
Ordinary Shares, Par Value $0.001 6,223 I See Footnote(2)
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 (3) 05/31/2018 Ordinary Shares 249,000 $7.5 D
Warrants to Purchase Ordinary Shares (3) 05/31/2018 Ordinary Shares 18,671 $7.5 I See Footnote(1)
Warrants to Purchase Ordinary Shares (3) 05/31/2018 Ordinary Shares 18,671 $7.5 I See Footnote(2)
Explanation of Responses:
1. Shares indirectly held in the name of Moksha Capital Partners Re (P) Ltd. The reporting person disclaims beneficial ownership 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.
2. Shares indirectly held by the reporting person's spouse in the name of Moksha Capital Partners Re (P) Ltd. The reporting person disclaims beneficial ownership 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. Currenty exercisable.
Remarks:
/s/ Mayur Patel 03/26/2014
** 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.