0001209191-24-005784.txt : 20240603 0001209191-24-005784.hdr.sgml : 20240603 20240603163929 ACCESSION NUMBER: 0001209191-24-005784 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240530 FILED AS OF DATE: 20240603 DATE AS OF CHANGE: 20240603 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BROWN MICHAEL J CENTRAL INDEX KEY: 0001280417 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 241014307 MAIL ADDRESS: STREET 1: 200 WEST CONGRESS STREET CITY: LAFAYETTE STATE: LA ZIP: 70501 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 2024-05-30 0 0001018979 AMERISAFE INC AMSF 0001280417 BROWN MICHAEL J 5 ROSA PARK NEW ORLEANS LA 70115 1 0 0 0 0 Common stock, par value $0.01 2024-05-30 4 P 0 1000 43.52 A 10055 D Kathryn H. Shirley, attorney-in-fact for Michael J. Brown 2024-06-03