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.

 

  Commission File Number:  001-14795

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:

 

Rule 12g-4(a)(l)

  

x

Rule 12g-4(a)(2)

  

¨

Rule 12h-3(b)(l)(i)

  

x

Rule 12h-3(b)(l)(ii)

  

¨

Rule 15d-6

  

¨

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.

 

   

AMERICAN SAFETY

INSURANCE HOLDINGS, LTD.

Date: October 15, 2013     By:   /s/ Nicholas C. Bentley
    Name:   Nicholas C. Bentley
    Title:   President
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