0001181431-12-036959.txt : 20120618
0001181431-12-036959.hdr.sgml : 20120618
20120618121856
ACCESSION NUMBER: 0001181431-12-036959
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120615
FILED AS OF DATE: 20120618
DATE AS OF CHANGE: 20120618
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gau Brendan
CENTRAL INDEX KEY: 0001466489
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 12911772
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 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
rrd348999.xml
20120615BGAULTIPRESTRICTED
X0305
4
2012-06-15
0
0001018979
AMERISAFE INC
AMSF
0001466489
Gau Brendan
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
Exec.VP & Chief Investment Of.
Common Stock, par value $0.01
2012-06-15
4
A
0
955
0
A
18455
D
Restricted shares which fully vest March 22, 2015.
/s/ Brendan Gau
2012-06-18