0001209191-22-027586.txt : 20220506 0001209191-22-027586.hdr.sgml : 20220506 20220506161627 ACCESSION NUMBER: 0001209191-22-027586 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220505 FILED AS OF DATE: 20220506 DATE AS OF CHANGE: 20220506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McCray Andrew B. CENTRAL INDEX KEY: 0001777423 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 22901270 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 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-05-05 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 2022-05-05 4 P 0 200 46.87 A 8199 D /s/Andrew B. McCray 2022-05-06