0001181431-13-056933.txt : 20131105
0001181431-13-056933.hdr.sgml : 20131105
20131105172151
ACCESSION NUMBER: 0001181431-13-056933
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20131104
FILED AS OF DATE: 20131105
DATE AS OF CHANGE: 20131105
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Frost G. Janelle
CENTRAL INDEX KEY: 0001449515
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 131193682
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
4
1
rrd394233.xml
FORM 4
X0306
4
2013-11-04
0
0001018979
AMERISAFE INC
AMSF
0001449515
Frost G. Janelle
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
President & COO
Common Stock, par value $0.01
2013-11-04
4
M
0
9000
9
A
12850
D
Common Stock, par value $0.01
2013-11-04
4
S
0
5176
39.44
D
7674
D
Common Stock, par value $0.01
2013-11-04
4
A
0
25000
0
A
32674
D
Employee Stock Option (right to purchase)
9
2013-11-04
4
M
0
9000
0
D
2005-11-17
2015-11-17
Common Stock
9000
10000
D
Represents the weighted average selling price of the Issuer's common stock. The range of the sales prices were between $39.40 and $39.56. 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 et each separate price.
Restricted shares which vest ratably over seven years beginning November 4, 2014.
/s/ G. Janelle Frost
2013-11-05