0001209191-19-032168.txt : 20190522
0001209191-19-032168.hdr.sgml : 20190522
20190522184930
ACCESSION NUMBER: 0001209191-19-032168
CONFORMED SUBMISSION TYPE: 4/A
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: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 19847236
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
4/A
1
doc4a.xml
FORM 4/A SUBMISSION
X0306
4/A
2019-05-20
2019-05-22
0
0001018979
AMERISAFE INC
AMSF
0001777423
McCray Andrew B.
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP-CUO
Common stock,par value $0.01
2019-05-20
4
A
0
9000
0.00
A
9000
D
This amendment is being filed to correct the vesting schedule for the restricted shares which vest in five annual installments on the graduated basis of 10%, 15%, 20%, 25% and 30%, beginning May 20, 2020, the first anniversary of the grant date.
/s/Kathryn H. Shirley, attorney-in-fact for Andrew B. McCray
2019-05-22