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