0001181431-12-037061.txt : 20120618 0001181431-12-037061.hdr.sgml : 20120618 20120618165720 ACCESSION NUMBER: 0001181431-12-037061 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20120615 FILED AS OF DATE: 20120618 DATE AS OF CHANGE: 20120618 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: YOUNG AUSTIN P CENTRAL INDEX KEY: 0001021469 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 12912937 MAIL ADDRESS: STREET 1: 6200 ARNOT CITY: HOUSTON STATE: TX ZIP: 77007 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 rrd348998.xml 20120615AYOUNGRESTRICTED X0305 4 2012-06-15 0 0001018979 AMERISAFE INC AMSF 0001021469 YOUNG AUSTIN P 2301 HIGHWAY 190 WEST DERIDDER LA 70634 1 0 0 0 Common Stock, par value $0.01 2012-06-15 4 A 0 1119 0 A 5390 D Common Stock, par value $0.01 5931 I Owned through Young 1999 Family Limited Liability Partnership Subject to restrictions that will lapse at the time of the 2013 annual shareholder's meeting. Excludes 3,247 shares previously owned directly which were transferred to the family limited partnership on January 26, 2011. /s/ G. Janelle Frost, attorney-in-fact for Austin P. Young, III 2012-06-18 EX-24.1 2 rrd313140_353549.htm POWER OF ATTORNEY OF AUSTIN P. YOUNG III rrd313140_353549.html 
POWER OF ATTORNEY

       	Know all by these presents, that the undersigned hereby constitutes and appoints each of C. Allen
Bradley, Jr., Percy McCraney, James O?Bannon, Paula S. Granger and G. Janelle Frost, or either of them
signing singly, and with full power of substitution, the undersigned's true and lawful attorney-in-fact to:

(1)	prepare, execute in the undersigned?s name and on the undersigned?s behalf, and submit
to the U.S. Securities and Exchange Commission (the ?SEC?) a Form ID, including
amendments thereto, and any other documents necessary or appropriate to obtain codes
and passwords enabling the undersigned to make electronic filings with the SEC of reports
required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation
of the SEC;

(2)	execute for and on behalf of the undersigned, in the undersigned's capacity as an officer
and/or director of AMERISAFE, Inc. (the ?Company?), Forms 3, 4, and 5 in accordance with
Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;

(3)		do and perform any and all acts for and on behalf of the undersigned which may be
necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and
execute any amendment or amendments thereto, and timely file such form with the SEC
and any stock exchange or similar authority; and

(4)	take any other action of any type whatsoever in connection with the foregoing which, in the
opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally
required by, the undersigned, it being understood that the documents executed by such
attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in
such form and shall contain such terms and conditions as such attorney-in-fact may
approve in such attorney-in-fact's discretion.

       	The undersigned hereby grants to each such attorney-in-fact full power and authority to do and
perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise
of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might
or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming
all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to
be done by virtue of this power of attorney and the rights and powers herein granted.  The undersigned
acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to
comply with Section 16 of the Securities Exchange Act of 1934.

       	This Power of Attorney shall remain in full force and effect until the undersigned is no longer
required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities
issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

       	IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of
this 2nd day of December, 2011.


		/s/ Austin P. Young, III