0001140361-11-057561.txt : 20111215
0001140361-11-057561.hdr.sgml : 20111215
20111215100039
ACCESSION NUMBER: 0001140361-11-057561
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111214
FILED AS OF DATE: 20111215
DATE AS OF CHANGE: 20111215
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BIRDWELL CODY W
CENTRAL INDEX KEY: 0001244782
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-14795
FILM NUMBER: 111262524
MAIL ADDRESS:
STREET 1: 100 GALLERIA PARKWAY, SE
STREET 2: SUITE 700
CITY: ATLANTA
STATE: GA
ZIP: 30339
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
X0304
4
2011-12-14
0
0000783603
AMERICAN SAFETY INSURANCE HOLDINGS LTD
ASI
0001244782
BIRDWELL CODY W
31 QUEEN STREET
2ND FLOOR
HAMILTON
D0
HM II
BERMUDA
1
0
0
0
Common Stock
2011-12-14
4
S
0
100
21.63
D
116539
D
Common Stock
2011-12-14
4
S
0
120
21.62
D
116419
D
Common Stock
2011-12-14
4
S
0
900
21.61
D
115519
D
Common Stock
2011-12-14
4
S
0
3880
21.55
D
111639
D
Common Stock
98250
I
Shares owned by the Cody Birdwell Family Limited Partnership
Cody W. Birdwell
2011-12-15