0001181431-13-060331.txt : 20131122
0001181431-13-060331.hdr.sgml : 20131122
20131122155509
ACCESSION NUMBER: 0001181431-13-060331
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20131120
FILED AS OF DATE: 20131122
DATE AS OF CHANGE: 20131122
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: Roach Randy
CENTRAL INDEX KEY: 0001391169
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 131238223
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634-6006
4
1
rrd395915.xml
FORM 4
X0306
4
2013-11-20
0
0001018979
AMERISAFE INC
AMSF
0001391169
Roach Randy
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
1
0
0
0
Common Stock, par value $0.01
2013-11-20
4
S
0
200
40.50
D
7953
D
The shares were formerly held by the Reporting Person's spouse in her IRA.
/s/ Kathryn H. Rowan, attorney-in-fact for Randall Roach
2013-11-22