0001209191-17-019328.txt : 20170308 0001209191-17-019328.hdr.sgml : 20170308 20170308171644 ACCESSION NUMBER: 0001209191-17-019328 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170307 FILED AS OF DATE: 20170308 DATE AS OF CHANGE: 20170308 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: 17675956 MAIL ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-03-07 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 2017-03-07 4 S 0 823 64.10 D 54783 D Represents restricted stock that fully vested on March 5, 2017. The shares were sold pursuant to the Reporting Person's 10b5-1 plan to cover taxes. /s/G. Janelle Frost 2017-03-08