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