0001209191-22-048625.txt : 20220906
0001209191-22-048625.hdr.sgml : 20220906
20220906070756
ACCESSION NUMBER: 0001209191-22-048625
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220901
FILED AS OF DATE: 20220906
DATE AS OF CHANGE: 20220906
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Omiridis Anastasios
CENTRAL INDEX KEY: 0001789494
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 221226839
MAIL ADDRESS:
STREET 1: 200 EAST RANDOLPH STREET
STREET 2: SUITE 3300
CITY: CHICAGO
STATE: IL
ZIP: 60601
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
2022-09-01
1
0001018979
AMERISAFE INC
AMSF
0001789494
Omiridis Anastasios
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP-CFO
/s/Kathryn H. Shirley attorney-in-fact for Anastasios Omiridis
2022-09-06