0001209191-15-082081.txt : 20151124
0001209191-15-082081.hdr.sgml : 20151124
20151124182337
ACCESSION NUMBER: 0001209191-15-082081
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20151109
FILED AS OF DATE: 20151124
DATE AS OF CHANGE: 20151124
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: Gau Brendan
CENTRAL INDEX KEY: 0001466489
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 151253901
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
4/A
1
doc4a.xml
FORM 4/A SUBMISSION
X0306
4/A
2015-11-09
2015-11-11
0
0001018979
AMERISAFE INC
AMSF
0001466489
Gau Brendan
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
Exec.VP & Chief Investment Of.
Common stock, par value $0.01
2015-11-09
4
M
0
435
15.60
A
21791
D
Common stock, par value $0.01
2015-11-09
4
S
0
435
54.00
D
21356
D
Employee Stock Option (right to purchase)
15.60
2015-11-09
4
M
0
435
0.00
D
2012-08-07
2019-08-07
Common stock, par value $0.01 per share
435
34277
D
Amendment file to 1) correct transaction codes and 2) include the correct acquisition price of securities in Table I.
The stock options became exercisable in five equal installments beginning on August 7, 2010, which was the first anniversary of the grant date.
/s/ Brendan Gau
2015-11-24