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Shelby Insurance Co., et al. – ‘4’ for 11/10/04 re: Affirmative Insurance Holdings Inc.

On:  Friday, 11/19/04, at 4:12pm ET   ·   For:  11/10/04   ·   As:  10% Owner   ·   Accession #:  1183733-4-300   ·   File #:  0-50795

Previous ‘4’:  ‘4’ on 9/30/04 for 9/28/04   ·   Latest ‘4’:  This Filing

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

11/19/04  Shelby Insurance Co.              4          10% Owner   1:11K  Affirmative Ins Holdings Inc.     Balch & Bingham LLP/FA
          Vesta Fire Insurance Corp.
          Vesta Insurance Group Inc.

Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 4   —   SEA’34
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 4           Statement of Changes in Beneficial Ownership of     HTML     11K 
                Securities by an Insider -- edgar.xml/2.2


        

This ‘4’ Document is an XML Data File that may be rendered in various formats:

  Form 4    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 
 
XML Data rendering:  Statement of Changes in Beneficial Ownership of Securities by an Insider
 
                                                                                                                                                                                
<?xml version="1.0" encoding="windows-1252"?>
<ownershipDocument>
<schemaVersion> X0202 </schemaVersion>
<documentType> 4 </documentType>
<periodOfReport> 2004-11-10 </periodOfReport>
<issuer>
<issuerCik> 0001282543 </issuerCik>
<issuerName> AFFIRMATIVE INSURANCE HOLDINGS INC </issuerName>
<issuerTradingSymbol> AFFM </issuerTradingSymbol>
</issuer>
<reportingOwner>
<reportingOwnerId>
<rptOwnerCik> 0000911576 </rptOwnerCik>
<rptOwnerName> VESTA INSURANCE GROUP INC </rptOwnerName>
</reportingOwnerId>
<reportingOwnerAddress>
<rptOwnerStreet1> 3760 RIVER RUN DRIVE </rptOwnerStreet1>
<rptOwnerStreet2></rptOwnerStreet2>
<rptOwnerCity> BIRMINGHAM </rptOwnerCity>
<rptOwnerState> AL </rptOwnerState>
<rptOwnerZipCode> 35243 </rptOwnerZipCode>
<rptOwnerStateDescription></rptOwnerStateDescription>
</reportingOwnerAddress>
<reportingOwnerRelationship>
<isDirector> 0 </isDirector>
<isOfficer> 0 </isOfficer>
<isTenPercentOwner> 1 </isTenPercentOwner>
<isOther> 0 </isOther>
</reportingOwnerRelationship>
</reportingOwner>
<reportingOwner>
<reportingOwnerId>
<rptOwnerCik> 0001296510 </rptOwnerCik>
<rptOwnerName> Vesta Fire Insurance CORP </rptOwnerName>
</reportingOwnerId>
<reportingOwnerAddress>
<rptOwnerStreet1> 3760 RIVER RUN DRIVE </rptOwnerStreet1>
<rptOwnerStreet2></rptOwnerStreet2>
<rptOwnerCity> BIRMINGHAM </rptOwnerCity>
<rptOwnerState> AL </rptOwnerState>
<rptOwnerZipCode> 35243 </rptOwnerZipCode>
<rptOwnerStateDescription></rptOwnerStateDescription>
</reportingOwnerAddress>
<reportingOwnerRelationship>
<isDirector> 0 </isDirector>
<isOfficer> 0 </isOfficer>
<isTenPercentOwner> 1 </isTenPercentOwner>
<isOther> 0 </isOther>
</reportingOwnerRelationship>
</reportingOwner>
<reportingOwner>
<reportingOwnerId>
<rptOwnerCik> 0000817425 </rptOwnerCik>
<rptOwnerName> SHELBY INSURANCE CO </rptOwnerName>
</reportingOwnerId>
<reportingOwnerAddress>
<rptOwnerStreet1> 3760 RIVER RUN DRIVE </rptOwnerStreet1>
<rptOwnerStreet2></rptOwnerStreet2>
<rptOwnerCity> BIRMINGHAM </rptOwnerCity>
<rptOwnerState> AL </rptOwnerState>
<rptOwnerZipCode> 35243 </rptOwnerZipCode>
<rptOwnerStateDescription></rptOwnerStateDescription>
</reportingOwnerAddress>
<reportingOwnerRelationship>
<isDirector> 0 </isDirector>
<isOfficer> 0 </isOfficer>
<isTenPercentOwner> 1 </isTenPercentOwner>
<isOther> 0 </isOther>
</reportingOwnerRelationship>
</reportingOwner>
<nonDerivativeTable>
<nonDerivativeTransaction>
<securityTitle>
<value> Common Stock </value>
<footnoteId id="F1"/>
</securityTitle>
<transactionDate>
<value> 2004-11-10 </value>
</transactionDate>
<transactionCoding>
<transactionFormType> 4 </transactionFormType>
<transactionCode> J </transactionCode>
<equitySwapInvolved> 0 </equitySwapInvolved>
<footnoteId id="F2"/>
</transactionCoding>
<transactionAmounts>
<transactionShares>
<value> 2397706 </value>
<footnoteId id="F2"/>
</transactionShares>
<transactionPricePerShare>
<footnoteId id="F2"/>
</transactionPricePerShare>
<transactionAcquiredDisposedCode>
<value> D </value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 0 </value>
<footnoteId id="F3"/>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
<footnoteId id="F3"/>
</directOrIndirectOwnership>
<natureOfOwnership>
<value></value>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeTransaction>
<nonDerivativeTransaction>
<securityTitle>
<value> Common Stock </value>
</securityTitle>
<transactionDate>
<value> 2004-11-15 </value>
</transactionDate>
<transactionCoding>
<transactionFormType> 4 </transactionFormType>
<transactionCode> J </transactionCode>
<equitySwapInvolved> 0 </equitySwapInvolved>
<footnoteId id="F4"/>
</transactionCoding>
<transactionAmounts>
<transactionShares>
<value> 1470000 </value>
<footnoteId id="F4"/>
</transactionShares>
<transactionPricePerShare>
<footnoteId id="F4"/>
</transactionPricePerShare>
<transactionAcquiredDisposedCode>
<value> D </value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 3350522 </value>
<footnoteId id="F5"/>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
<footnoteId id="F5"/>
</directOrIndirectOwnership>
<natureOfOwnership>
<value></value>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeTransaction>
<nonDerivativeTransaction>
<securityTitle>
<value> Common Stock </value>
</securityTitle>
<transactionDate>
<value> 2004-11-10 </value>
</transactionDate>
<transactionCoding>
<transactionFormType> 4 </transactionFormType>
<transactionCode> J </transactionCode>
<equitySwapInvolved> 0 </equitySwapInvolved>
<footnoteId id="F2"/>
</transactionCoding>
<transactionAmounts>
<transactionShares>
<value> 2397706 </value>
<footnoteId id="F2"/>
</transactionShares>
<transactionPricePerShare>
<footnoteId id="F2"/>
</transactionPricePerShare>
<transactionAcquiredDisposedCode>
<value> A </value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 2397706 </value>
<footnoteId id="F6"/>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
<footnoteId id="F6"/>
</directOrIndirectOwnership>
<natureOfOwnership>
<value></value>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeTransaction>
<nonDerivativeTransaction>
<securityTitle>
<value> Common Stock </value>
</securityTitle>
<transactionDate>
<value> 2004-11-15 </value>
</transactionDate>
<transactionCoding>
<transactionFormType> 4 </transactionFormType>
<transactionCode> J </transactionCode>
<equitySwapInvolved> 0 </equitySwapInvolved>
<footnoteId id="F4"/>
</transactionCoding>
<transactionAmounts>
<transactionShares>
<value> 1470000 </value>
<footnoteId id="F4"/>
</transactionShares>
<transactionPricePerShare>
<footnoteId id="F4"/>
</transactionPricePerShare>
<transactionAcquiredDisposedCode>
<value> A </value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 3867706 </value>
<footnoteId id="F6"/>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
<footnoteId id="F6"/>
</directOrIndirectOwnership>
<natureOfOwnership>
<value></value>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeTransaction>
</nonDerivativeTable>
<footnotes>
<footnote id="F1"> This form is being filed to report two intercompany transfers among Vesta Insurance Group, Inc., Vesta Fire Insurance Corporation and The Shelby Insurance Company, which are joint filers of this report. The Shelby Insurance Company is a wholly-owned subsidiary of Vesta Fire Insurance Corporation, which is in turn a wholly-owned subsidiary of Vesta Insurance Group, Inc. From the date of the joint filers' last report on Form 4, there has been no change in the total amount of shares owned, directly or indirectly, by Vesta Insurance Group, Inc. as the ultimate parent company of the other joint filers. The joint filers consider the reported transactions to be exempt changes in form of beneficial ownership. </footnote>
<footnote id="F2"> On November 10, 2004, The Shelby Insurance Company dividended to its parent company, Vesta Fire Insurance Corporation, all 2,397,706 shares it owned. </footnote>
<footnote id="F3"> Shares owned directly by The Shelby Insurance Company. The Shelby Insurance Company is no longer the beneficial owner of any of the issuer's shares and is no longer subject to Section 16 with respect thereto. </footnote>
<footnote id="F4"> On November 15, 2004, Vesta Insurance Group, Inc. contributed 1,470,000 shares to its subsidiary, Vesta Fire Insurance Corporation. </footnote>
<footnote id="F5"> Shares owned directly by Vesta Insurance Group, Inc. </footnote>
<footnote id="F6"> Shares owned directly by Vesta Fire Insurance Corporation. Vesta Insurance Group, Inc. is an indirect beneficial owner of the reported securities. </footnote>
</footnotes>
<remarks></remarks>
<ownerSignature>
<signatureName> /s/ John W. McCullough, Vice President and Associate General Counsel, Vesta Insurance Group, Inc. </signatureName>
<signatureDate> 2004-11-19 </signatureDate>
</ownerSignature>
<ownerSignature>
<signatureName> /s/ John W. McCullough, Authorized Representative, Vesta Fire Insurance Corporation </signatureName>
<signatureDate> 2004-11-19 </signatureDate>
</ownerSignature>
<ownerSignature>
<signatureName> /s/ John W. McCullough, Authorized Representative, The Shelby Insurance Company </signatureName>
<signatureDate> 2004-11-19 </signatureDate>
</ownerSignature>
</ownershipDocument>


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Filing Submission 0001183733-04-000300   –   Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)
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