-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, TfUieyOHdziA7zwbCUlskbEK7lhRylS0RoeO4elL4OQTSIcKyscBqsnjHeN1bqlu CYrwDqqH88uENiT7/AxUaw== 0000904454-09-000093.txt : 20090217 0000904454-09-000093.hdr.sgml : 20090216 20090217183120 ACCESSION NUMBER: 0000904454-09-000093 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20080310 FILED AS OF DATE: 20090217 DATE AS OF CHANGE: 20090217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TRAYNOR SEAN CENTRAL INDEX KEY: 0001212999 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 09616457 BUSINESS ADDRESS: BUSINESS PHONE: 2128939500 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERISAFE INC CENTRAL INDEX KEY: 0001018979 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 752069407 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 BUSINESS PHONE: 337-463-9052 MAIL ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 4/A 1 edgar.xml PRIMARY DOCUMENT X0303 4/A 2008-03-10 2008-05-27 0001018979 AMERISAFE INC AMSF 0001212999 TRAYNOR SEAN C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 1 0 0 0 Common Stock 2008-03-10 4 J 0 2055 D 851 D Shares issued to the Reporting Person as a director of the Issuer transferred to WCAS Management Corporation pursuant to the terms of the applicable management company agreement. David Mintz, Attorney-in-Fact 2009-02-17 -----END PRIVACY-ENHANCED MESSAGE-----