0001181431-13-000340.txt : 20130102
0001181431-13-000340.hdr.sgml : 20130101
20130102170346
ACCESSION NUMBER: 0001181431-13-000340
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130102
FILED AS OF DATE: 20130102
DATE AS OF CHANGE: 20130102
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BRADLEY C ALLEN JR
CENTRAL INDEX KEY: 0001341775
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 13502647
MAIL ADDRESS:
STREET 1: AMERISAFE INC
STREET 2: 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
rrd365330.xml
2013JAN02BRADLEYFORM4
X0306
4
2013-01-02
0
0001018979
AMERISAFE INC
AMSF
0001341775
BRADLEY C ALLEN JR
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
1
1
0
0
Chairman and CEO
Common stock, par value $.01
2013-01-02
4
M
0
10000
9.00
A
64798
D
Common stock, par value $.01
2013-01-02
4
S
0
5980
27.81
D
58818
D
Employee Stock Option (right to purchase)
9
2013-01-02
4
M
0
10000
0
D
2006-11-17
2015-11-17
Common Stock
10000
409000
D
Transaction completed pursuant to 10b5-1 Plan executed while officer was not in possession of material non-public information.
Represents the weighted average selling price of the Issuer's common stock. The range of the sales prices were between $27.69 and $27.87. The Reporting Person undertakes, upon request, to provide the SEC, the Issuer and any security holder of the Issuer full information regarding the number of shares sold at each separate price.
These options were granted on 11/17/2005 and vested in five, equal installments, commencing on the first anniversary of the grant date.
C. Allen Bradley, Jr.
2013-01-02