0001181431-11-016397.txt : 20110308
0001181431-11-016397.hdr.sgml : 20110308
20110308134620
ACCESSION NUMBER: 0001181431-11-016397
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110307
FILED AS OF DATE: 20110308
DATE AS OF CHANGE: 20110308
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Walker Todd Richard
CENTRAL INDEX KEY: 0001374459
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 11671395
MAIL ADDRESS:
STREET 1: 2301 HWY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
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
1
rrd304590.xml
20110308WALKERFORM4
X0303
4
2011-03-07
0
0001018979
AMERISAFE INC
AMSF
0001374459
Walker Todd Richard
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP/General Counsel
Common Stock, par value $.01
2011-03-07
4
M
0
8500
9.98
A
12640
D
Common Stock, par value $.01
2011-03-07
4
S
0
5541
20.3164
D
7099
D
Common Stock, par value $.01
2011-03-08
4
M
0
11500
9.98
A
18599
D
Common Stock, par value $.01
2011-03-08
4
S
0
10975
20.7545
D
7624
D
Employee Stock Option (right to buy)
9.98
2011-03-07
4
M
0
8500
0
D
2007-09-25
2016-09-25
Common Stock, par value $.01
8500
41500
D
Employee Stock Option (right to purchase)
9.98
2011-03-08
4
M
0
11500
0
D
2008-09-25
2016-09-25
Common Stock, par value $.01
11500
30000
D
The price reported in column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $20.21 to $20.36, inclusive.
The price reported in column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $20.35 to $21.06, inclusive.
These options to purchase were issued on 09/25/2006, and vest yearly in five equal increments. On the date of this report 10,000 of the options remain unvested.
/s/Todd Walker
2011-03-08