Termination of Registration of a Class of Security Under Section 12(b) (15-12b)
October 15 2013 - 1:21PM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 15
CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER SECTION
12(G) OF THE SECURITIES EXCHANGE ACT OF 1934 OR SUSPENSION OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934.
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Commission File Number:
001-14795
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AMERICAN SAFETY INSURANCE HOLDINGS, LTD.
(Exact name of registrant as specified in its charter)
The Boyle
Building, 2nd Floor
31 Queen Street
Hamilton, Bermuda HM 11
(441) 296-8560
(Address,
including zip code, and telephone number, including area code, of registrant’s principal executive offices)
Common
Shares, par value $0.01 per share
(Title of each class of securities covered by this Form)
N/A
(Titles of all other
classes of securities for which a duty to file reports under section 13(a) or 15(d) remains)
Please place an X in the
box(es) to designate the appropriate rule provision(s) relied upon to terminate or suspend the duty to file reports:
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Rule 12g-4(a)(l)
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x
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Rule 12g-4(a)(2)
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¨
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Rule 12h-3(b)(l)(i)
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x
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Rule 12h-3(b)(l)(ii)
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¨
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Rule 15d-6
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¨
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Approximate number of holders of record as of the certification or notice date: 1
Pursuant to the requirements of the Securities Exchange Act of 1934, American Safety Insurance Holdings, Ltd. has caused this
certification/notice to be signed on its behalf by the undersigned duly authorized person.
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AMERICAN SAFETY
INSURANCE
HOLDINGS, LTD.
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Date: October 15, 2013
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By:
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/s/ Nicholas C. Bentley
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Name:
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Nicholas C. Bentley
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Title:
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President
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