0001181431-14-035994.txt : 20141110
0001181431-14-035994.hdr.sgml : 20141110
20141110163117
ACCESSION NUMBER: 0001181431-14-035994
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20141107
FILED AS OF DATE: 20141110
DATE AS OF CHANGE: 20141110
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: LEACH CRAIG P
CENTRAL INDEX KEY: 0001342814
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 141209095
MAIL ADDRESS:
STREET 1: AMERISAFE INC
STREET 2: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
4
1
rrd418682.xml
FORM 4
X0306
4
2014-11-07
0
0001018979
AMERISAFE INC
AMSF
0001342814
LEACH CRAIG P
AMERISAFE, INC.
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP, Sales and Marketing
Common Stock, par value $.01
2014-11-07
4
M
0
7016
8.50
A
8031
D
Common Stock, par value $.01
2014-11-07
4
S
0
7016
41.18
D
1015
D
Employee Stock Option (right to buy)
8.50
2014-11-07
4
M
0
7016
0
D
2009-11-17
2015-11-17
Common Stock, par value $.01
7016
0
D
Represents the weighted average selling price of the Issuer's common stock. The range of the sales prices were between $41.09 and $41.52. 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.
/s/ Craig P. Leach
2014-11-10