forms3a20110120.htm
 
 
 



 

 
 
SECURITIES AND EXCHANGE COMMISSION
 

 
Washington, D.C. 20549
 
PRE-EFFECTIVE AMENDMENT NO. 1
TO
FORM S-3
REGISTRATION STATEMENT

UNDER THE SECURITIES ACT OF 1933
 
American Safety Insurance Holdings, Ltd.
 
American Safety Holdings Corp.
American Safety Capital Trust IV
(Exact name of registrant as specified in its charter)
 
Bermuda
Georgia
Georgia
  
N/A
58-248367
To be applied for
(State or other jurisdiction of
incorporation or organization)
  
(I.R.S. Employer
Identification No.)

 
31 Queen Street
2nd Floor
Hamilton, Bermuda HM 11
(441) 296-8560

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)

Randolph L. Hutto
General Counsel and Corporate Secretary
American Safety Insurance Holdings, Ltd.
2nd Floor
Hamilton, Bermuda HM 11
(441) 296-8560

(Name, address, including zip code, and telephone number, including area code, of agent for service)

The Registrant hereby amends this Registration Statement on such date or dates as may be necessary to delay its effective date until the Registrant shall file a further amendment which specifically states that this Registration Statement shall thereafter become effective in accordance with Section 8(a) of the Securities Act of 1933, as amended, or until this Registration Statement shall become effective on such date as the Commission, acting pursuant to said Section 8(a), may determine.
 
 
 
 
 
SIGNATURES
 
Pursuant to the requirements of the Securities Act of 1933, the registrant has duly caused this Amendment No. 1 to the Registration Statement to be signed on its behalf by the undersigned, thereunto duly authorized, on the 11th day of January 2011.
 
AMERICAN SAFETY INSURANCE HOLDINGS, LTD.
(Registrant)
 
By:           /s/ Stephen R. Crim                                                      
Name:        Stephen R. Crim
Title:          President & Chief Executive Officer
 
Pursuant to the requirements of the Securities Act of 1933, this Amendment No. 1 to the Registration Statement has been signed by the following persons in the capacities indicated on the 11th day of January 2011.
 
 

 
Signature
Title
         /s/ Stephen R. Crim                        
Stephen R. Crim
 
President & Chief Executive Officer
(Principal Executive Officer)
   /s/ Mark W. Haushill                        
Mark W. Haushill
Chief Financial Officer and Treasurer
(Principal Financial Officer and Principal Accounting Officer)
 
    David V. Brueggen*                                              
David V. Brueggen
 
Chairman of the Board
 
    Cody W. Birdwell*                                        
Cody W. Birdwell
 
Director
     Harris Chorney                                         
Harris Chorney 
 
Director
    Steven L. Groot                                                     
Steven L. Groot 
 
Director
    Marilyn V. Hirsch*                                         
Marilyn V. Hirsch
 
Director
    Thomas W. Mueller*                                                     
Thomas W. Mueller
 
Director
  /s/ Stephen R. Crim*                                   
Stephen R. Crim, attorney-in-fact pursuant to previously filed power of attorney