x None
Entity Type
0001539894
 
x Corporation
o Limited Partnership
o Limited Liability Company
o General Partnership
o Business Trust
o Other
Name of Issuer
 Atlas Financial Holdings, Inc.
Jurisdiction of Incorporation/Organization
CAYMAN ISLANDS
 
Year of Incorporation/Organization
  x Over Five Years Ago
  o Within Last Five Years (Specify Year)  
  o Yet to Be Formed  



2. Principal Place of Business and Contact Information
Name of Issuer  
 Atlas Financial Holdings, Inc.  
Street Address 1 Street Address 2
 953 AMERICAN LANE, 3RD FLOOR  
City State/Province/Country ZIP/Postal Code Phone No. of Issuer
 SCHAUMBURG  ILLINOIS  60173  847-472-6700 



3. Related Persons
Last Name First Name Middle Name
Wollney Scott
Street Address 1 Street Address 2
953 American Lane 3rd Floor
City State/Province/Country ZIP/Postal Code
Schaumburg ILLINOIS 60173
Relationship: x Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
   

Last Name First Name Middle Name
Romano Paul A
Street Address 1 Street Address 2
953 American Lane 3rd Floor
City State/Province/Country ZIP/Postal Code
Schaumburg ILLINOIS 60173
Relationship: x Executive Officer o Director o Promoter
Clarification of Response (if Necessary)
   

Last Name First Name Middle Name
Kupinsky Jordan
Street Address 1 Street Address 2
953 American Lane 3rd Floor
City State/Province/Country ZIP/Postal Code
Schaumburg ILLINOIS 60173
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
   

Last Name First Name Middle Name
Konezny Ronald
Street Address 1 Street Address 2
953 American Lane 3rd Floor
City State/Province/Country ZIP/Postal Code
Schaumburg ILLINOIS 60173
Relationship: o Executive Officer x Director o Promoter
Clarification of Response (if Necessary)
   

 


4. Industry Group
o Agriculture   Health Care o Retailing
  Banking & Financial Services   o Biotechnology o Restaurants
  o Commercial Banking   o Health Insurance   Technology
  x Insurance   o Hospitals & Physicians   o Computers
  o Investing   o Pharmaceuticals   o Telecommunications
  o Investment Banking   o Other Health Care   o Other Technology
  o Pooled Investment Fund

        Travel
  o Other Banking & Financial Services o Manufacturing   o Airlines & Airports
  Real Estate   o Lodging & Conventions
  o Commercial   o Tourism & Travel Services
  o Construction   o Other Travel
  o REITS & Finance o Other
  o Residential  
  o Other Real Estate  
o Business Services  
  Energy  
  o Coal Mining  
  o Electric Utilities  
  o Energy Conservation  
  o Environmental Services  
  o Oil & Gas  
  o Other Energy  


5. Issuer Size
Revenue Range Aggregate Net Asset Value Range
o No Revenues o No Aggregate Net Asset Value
o $1 - $1,000,000 o $1 - $5,000,000
o $1,000,001 - $5,000,000 o $5,000,001 - $25,000,000
o $5,000,001 - $25,000,000 o $25,000,001 - $50,000,000
o $25,000,001 - $100,000,000 o $50,000,001 - $100,000,000
o Over $100,000,000 o Over $100,000,000
x Decline to Disclose o Decline to Disclose
o Not Applicable o Not Applicable


6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)
o Rule 504(b)(1) (not (i), (ii) or (iii)) o Rule 505
o Rule 504 (b)(1)(i) x Rule 506(b)
o Rule 504 (b)(1)(ii) o Rule 506(c)
o Rule 504 (b)(1)(iii) o Securities Act Section 4(a)(5)
  o Investment Company Act Section 3(c)

7. Type of Filing
x New Notice Date of First Sale  2021-09-01 o First Sale Yet to Occur
o Amendment

8. Duration of Offering
Does the Issuer intend this offering to last more than one year? o Yes x No

9. Type(s) of Securities Offered (select all that apply)
o Pooled Investment Fund Interests x Equity
o Tenant-in-Common Securities o Debt
o Mineral Property Securities o Option, Warrant or Other Right to Acquire Another Security
o Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security o Other (describe)
   


10. Business Combination Transaction
Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? o Yes x No
 
Clarification of Response (if Necessary)  
  

11. Minimum Investment
Minimum investment accepted from any outside investor $ 0 USD

12. Sales Compensation
Recipient Recipient CRD Number o None
   
(Associated) Broker or Dealer o None (Associated) Broker or Dealer CRD Number o None
   
Street Address 1 Street Address 2
   
City State/Province/Country ZIP/Postal Code
     
State(s) of Solicitation o All States
 
 



13. Offering and Sales Amounts
Total Offering Amount $   USD x Indefinite
Total Amount Sold $ 0 USD  
Total Remaining to be Sold $   USD x Indefinite
 
Clarification of Response (if Necessary)
 The Issuer issued an aggregate of 2,750,000 of the issuer's ordinary shares as additional consideration to lenders under a credit agreement. No monetary consideration was paid to the Issuer as a result of this issuance.


14. Investors
o Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering
 
  Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: 4


15. Sales Commissions & Finders’ Fees Expenses
Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
Sales Commissions $ 0 USD o Estimate
Finders' Fees $ 0 USD o Estimate
 
Clarification of Response (if Necessary)
  


16. Use of Proceeds
Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
  $ 0 USD o
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