-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, D8K1qnlhtUeQDVQkX6B1e9D/W7Z0YwQfj1iy8sdAECwGz6Bpcs9hdhvrEwUIheKc FfAxG+tl411hx1ameR9iYA== 0001209191-06-067031.txt : 20061227 0001209191-06-067031.hdr.sgml : 20061227 20061227114035 ACCESSION NUMBER: 0001209191-06-067031 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20061222 FILED AS OF DATE: 20061227 DATE AS OF CHANGE: 20061227 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NARIGON DAVID O CENTRAL INDEX KEY: 0001199862 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 061299939 BUSINESS ADDRESS: STREET 1: P O BOX712 CITY: DES MOINES STATE: IA ZIP: 50303-0712 BUSINESS PHONE: 5152802658 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 doc4.xml FORM 4 SUBMISSION X0202 4 2006-12-22 0 0001018979 AMERISAFE INC AMSF 0001199862 NARIGON DAVID O 2301 HIGHWAY 190 WEST DERIDDER LA 70634 0 1 0 0 Executive Vice President Common Stock, par value $.01 per share 2006-12-22 4 P 0 10000 14.84 A 10000 D /s/ Todd Walker Todd Walker, Attorney-in-Fact for David Narigon, Executive Vice President 2006-12-26 -----END PRIVACY-ENHANCED MESSAGE-----