0001209191-19-032112.txt : 20190522 0001209191-19-032112.hdr.sgml : 20190522 20190522170800 ACCESSION NUMBER: 0001209191-19-032112 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190520 FILED AS OF DATE: 20190522 DATE AS OF CHANGE: 20190522 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McCray Andrew B. CENTRAL INDEX KEY: 0001777423 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 19846682 MAIL ADDRESS: STREET 1: 2301 HIGHWAY 27 CITY: DERIDDER STATE: LA ZIP: 70634 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 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2019-05-20 1 0001018979 AMERISAFE INC AMSF 0001777423 McCray Andrew B. 2301 HIGHWAY 190 WEST DERIDDER LA 70634 0 1 0 0 EVP-CUO /s/Kathryn H. Shirley, attorney-in-fact for Andrew B. McCray 2019-05-22