0001181431-14-036294.txt : 20141113 0001181431-14-036294.hdr.sgml : 20141113 20141113130549 ACCESSION NUMBER: 0001181431-14-036294 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141111 FILED AS OF DATE: 20141113 DATE AS OF CHANGE: 20141113 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: BROWN MICHAEL J CENTRAL INDEX KEY: 0001280417 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 141217382 MAIL ADDRESS: STREET 1: 200 WEST CONGRESS STREET CITY: LAFAYETTE STATE: LA ZIP: 70501 3 1 rrd418886.xml FORM 3 X0206 3 2014-11-11 0 0001018979 AMERISAFE INC AMSF 0001280417 BROWN MICHAEL J 601 POYDRAS STREET SUITE 2100 NEW ORLEANS LA 70130 1 0 0 0 Common Stock, $.01 par value 0 D No Issuer securities benefically owned by reporting person on 11/11/2014. /s/ Kathryn H. Rowan, attorney-in-fact for Michael Brown 2014-11-13