0001209191-24-004346.txt : 20240305 0001209191-24-004346.hdr.sgml : 20240305 20240305161352 ACCESSION NUMBER: 0001209191-24-004346 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240301 FILED AS OF DATE: 20240305 DATE AS OF CHANGE: 20240305 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Omiridis Anastasios CENTRAL INDEX KEY: 0001789494 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 24720521 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] ORGANIZATION NAME: 02 Finance 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 X0508 4 2024-03-01 0 0001018979 AMERISAFE INC AMSF 0001789494 Omiridis Anastasios 2301 HIGHWAY 190 WEST DERIDDER LA 70634 0 1 0 0 EVP-CFO 0 Restricted Stock Unit 2024-03-01 4 A 0 1724 0.00 A Common Stock 1724 25057 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, 2027. /s/ Kathryn H. Shirley attorney-in-fact for Anastasios Omiridis 2024-03-05