-----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, UvSN/V7KfCGvxPDgKR18Cs0bN7Ht0tVufPh4oRnev9UXhs/F9aJBY/wWaIaXMglb sbRr2sxm9WyTeohXPX+QMw== 0000904454-09-000240.txt : 20090617 0000904454-09-000240.hdr.sgml : 20090617 20090617150628 ACCESSION NUMBER: 0000904454-09-000240 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090615 FILED AS OF DATE: 20090617 DATE AS OF CHANGE: 20090617 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TRAYNOR SEAN CENTRAL INDEX KEY: 0001212999 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 09896381 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 4 1 edgar.xml PRIMARY DOCUMENT X0303 4 2009-06-15 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 2009-06-15 4 A 0 974 0 A 2749 D Restricted stock award issued under the Issuer's Non-Employee Director Restricted Stock Plan. Such shares will vest at the time of the Issuer's 2010 annual meeting. David Mintz, Attorney-in-Fact 2009-06-17 -----END PRIVACY-ENHANCED MESSAGE-----