0001209191-16-148949.txt : 20161108
0001209191-16-148949.hdr.sgml : 20161108
20161108195715
ACCESSION NUMBER: 0001209191-16-148949
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161107
FILED AS OF DATE: 20161108
DATE AS OF CHANGE: 20161108
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: Frost G. Janelle
CENTRAL INDEX KEY: 0001449515
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 161982535
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-11-07
0
0001018979
AMERISAFE INC
AMSF
0001449515
Frost G. Janelle
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
President & CEO
Common stock, par value $0.01
2016-11-07
4
S
0
1715
54.87
D
55606
D
Represents restricted stock that fully vested on November 4, 2016. The shares were sold pursuant to the Reporting Person's 10b5-1 plan to cover taxes.
Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $54.70 and $55.10. The Reporting Person undertakes, upon request, to provide the SEC, the Issuer and any security holder of the Issuer, full information regarding the number of shares sold at each separate price.
/s/G. Janelle Frost
2016-11-08