0000904454-14-000396.txt : 20140430
0000904454-14-000396.hdr.sgml : 20140430
20140430131828
ACCESSION NUMBER: 0000904454-14-000396
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140320
FILED AS OF DATE: 20140430
DATE AS OF CHANGE: 20140430
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: 14797344
MAIL ADDRESS:
STREET 1: 320 PARK AVENUE STE 2500
CITY: NEW YORK
STATE: NY
ZIP: 10022
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2014-03-20
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
2014-03-20
4
J
0
5119
0
D
23
D
Shares transferred to WCAS Management Corporation pursuant to the terms of its organizational documents and the Reporting Person's agreement with WCAS Management Corporation.
/s/David Mintz, Attorney-in-Fact
2014-04-30