0001209191-23-044404.txt : 20230803
0001209191-23-044404.hdr.sgml : 20230803
20230803160828
ACCESSION NUMBER: 0001209191-23-044404
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230724
FILED AS OF DATE: 20230803
DATE AS OF CHANGE: 20230803
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Wise Raymond F. Jr.
CENTRAL INDEX KEY: 0001691779
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 231139970
MAIL ADDRESS:
STREET 1: 10375 PROFESSIONAL CIRCLE
CITY: RENO
STATE: NV
ZIP: 89521
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
2023-07-24
1
0001018979
AMERISAFE INC
AMSF
0001691779
Wise Raymond F. Jr.
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP - CSO
/s/Kathryn H. Shirley, attorney-in-fact for Raymond F. Wise
2023-08-03