-----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, SIDh0enp3iqZZVYu0IlGZNl4CyLlGZAvfbIg7tocQipXhb2jearH1WDk30ji8dSI zFebVXRKHz8S3EZV0tSpqQ== 0001181431-08-049648.txt : 20080821 0001181431-08-049648.hdr.sgml : 20080821 20080821173934 ACCESSION NUMBER: 0001181431-08-049648 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070816 FILED AS OF DATE: 20080821 DATE AS OF CHANGE: 20080821 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: YOUNG AUSTIN P CENTRAL INDEX KEY: 0001021469 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 081032958 BUSINESS ADDRESS: BUSINESS PHONE: 7138803810 MAIL ADDRESS: STREET 1: 6200 ARNOT CITY: HOUSTON STATE: TX ZIP: 77007 4/A 1 rrd216810.xml 20080821AYOUNG4A X0303 4/A 2007-08-16 2007-08-21 0 0001018979 AMERISAFE INC AMSF 0001021469 YOUNG AUSTIN P 2301 HIGHWAY 190 WEST DERIDDER LA 70634 1 0 0 0 Common stock, par value $.01 per share 2007-08-16 4 P 0 1851 13.50 A 2684 I By Young 1999 Family Limited Liability Partnership Common stock, par value $.01 per share 2571 D Mr. Young contributed the 1,851 shares purchased in this transaction, along with 833 shares of directly held previously restricted stock issued under the company's Non-Employee Director Restricted Stock Plan to the Young 1999 Family Limited Liability Partnership. In addition, 2,571 shares of directly held common shares were incorrectly reported as part of Mr. Young's indirect holdings. This will lower indirect holdings shown in future filings by 2,571 shares. Mr. Young contributed 833 shares of directly held previously restricted stock issued under the company's Non-Employee Director Restricted Stock Plan to the Young 1999 Family Limited Liability Partnership. This will lower direct holdings shown in future filings by 833 shares. /s/ Todd Walker, Attorney in Fact for Austin P. Young, III 2008-08-21 -----END PRIVACY-ENHANCED MESSAGE-----