0001209191-15-043977.txt : 20150518
0001209191-15-043977.hdr.sgml : 20150518
20150518190001
ACCESSION NUMBER: 0001209191-15-043977
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150514
FILED AS OF DATE: 20150518
DATE AS OF CHANGE: 20150518
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: BRADLEY C ALLEN JR
CENTRAL INDEX KEY: 0001341775
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 15874652
MAIL ADDRESS:
STREET 1: AMERISAFE INC
STREET 2: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2015-05-14
0
0001018979
AMERISAFE INC
AMSF
0001341775
BRADLEY C ALLEN JR
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
1
1
0
0
Chairman and CEO
Common stock, par value $0.01
2015-05-14
4
A
0
5956
0.00
A
147818
D
Shares issued for the 2012-2014 performance period under an award agreement between the reporting person and the Company pursuant to the Company's Equity and Incentive Compensation Plan. The awards were determined by the Compensation Committee of the Board of Directors of the Company on May 14, 2015 in accordance with the terms of the Plan and the related award agreement.
/s/ C. Allen Bradley, Jr.
2015-05-18