0001209191-23-015508.txt : 20230303
0001209191-23-015508.hdr.sgml : 20230303
20230303162846
ACCESSION NUMBER: 0001209191-23-015508
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: Shirley Kathryn Housh
CENTRAL INDEX KEY: 0001667972
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 23704536
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
0001667972
Shirley Kathryn Housh
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP - CAO
Restricted Stock Unit
2023-03-01
4
A
0
1047
0.00
A
Common stock
1047
1047
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/Kathryn H. Shirley
2023-03-03