0001209191-23-015467.txt : 20230303 0001209191-23-015467.hdr.sgml : 20230303 20230303161727 ACCESSION NUMBER: 0001209191-23-015467 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230301 FILED AS OF DATE: 20230303 DATE AS OF CHANGE: 20230303 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Frost G. Janelle CENTRAL INDEX KEY: 0001449515 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 23704229 MAIL ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST 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 2023-03-01 0 0001018979 AMERISAFE INC AMSF 0001449515 Frost G. Janelle 2301 HIGHWAY 190 WEST DERIDDER LA 70634 1 1 0 0 President & CEO Restricted Stock Unit 2023-03-01 4 A 0 4401 0.00 A Common stock 4401 4401 D Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. The restricted stock units fully vest March 1, 2026. /s/G. Janelle Frost 2023-03-03