-----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, BrcLy3sGILikFDnFdzLwedkcZ0OoDtLzF+F2ivE2od0swa3ERLJCGS0gkPfNtPuq uusv2Dpy1nK0UHtCY820VA== 0001209191-07-037324.txt : 20070615 0001209191-07-037324.hdr.sgml : 20070615 20070615161146 ACCESSION NUMBER: 0001209191-07-037324 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070614 FILED AS OF DATE: 20070615 DATE AS OF CHANGE: 20070615 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: Hallagan Thomas Winspear CENTRAL INDEX KEY: 0001363195 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 07923217 BUSINESS ADDRESS: BUSINESS PHONE: (212)706-9220 MAIL ADDRESS: STREET 1: 30 LINCOLN PLAZA, 18U CITY: NEW YORK STATE: NY ZIP: 10023 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2007-06-14 0 0001018979 AMERISAFE INC AMSF 0001363195 Hallagan Thomas Winspear 2301 HIGHWAY 190 WEST DERIDDER LA 70634 1 0 0 0 Common Stock, par value $.01 per share 2007-06-14 4 A 0 849 0.00 A 2071 D /s/ Wendy W. Walton, attorney-in-fact for Thomas W. Hallagan 2007-06-15 -----END PRIVACY-ENHANCED MESSAGE-----