-----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, AKsi169xUGS7tu68Q5qeBllCHiWW5Jz9Wsig1xbhBYXuDzsGtSNbMeVfMv1lES2I L9du8iNafLQjtwLGE/PS3A== 0001209191-07-047223.txt : 20070809 0001209191-07-047223.hdr.sgml : 20070809 20070809183956 ACCESSION NUMBER: 0001209191-07-047223 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070809 FILED AS OF DATE: 20070809 DATE AS OF CHANGE: 20070809 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: Walker Todd Richard CENTRAL INDEX KEY: 0001374459 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 071042289 BUSINESS ADDRESS: BUSINESS PHONE: (337)463-9052 MAIL ADDRESS: STREET 1: 2301 HWY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2007-08-09 0 0001018979 AMERISAFE INC AMSF 0001374459 Walker Todd Richard 2301 HIGHWAY 190 WEST DERIDDER LA 70634 0 1 0 0 Executive VP & General Counsel Common Stock, par value $.01 per share 2007-08-09 4 P 0 100 13.04 A 100 D Common Stock, par value $.01 per share 2007-08-09 4 P 0 600 13.05 A 700 D Common Stock, par value $.01 per share 2007-08-09 4 P 0 1300 13.06 A 2000 D /s/ Todd Walker 2007-08-09 -----END PRIVACY-ENHANCED MESSAGE-----