0001209191-16-104768.txt : 20160302
0001209191-16-104768.hdr.sgml : 20160302
20160302175351
ACCESSION NUMBER: 0001209191-16-104768
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160301
FILED AS OF DATE: 20160302
DATE AS OF CHANGE: 20160302
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: Shirley Kathryn Housh
CENTRAL INDEX KEY: 0001667972
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 161478684
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2016-03-01
0
0001018979
AMERISAFE INC
AMSF
0001667972
Shirley Kathryn Housh
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP, General Counsel
Common Stock, par value $0.01
13772
D
2,958 restricted shares were awarded May 29, 2012 that ratably vest over five years. 10,000 restricted shares will vest in five annual installments on a graduated basis of 10%, 15%, 20%, 25% and 30% beginning March 1, 2017, the first anniversary of the grant date. 814 restricted shares will fully vest on March 1, 2019.
/s/Kathryn H. Shirley
2016-03-02