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