0001209191-23-031879.txt : 20230524
0001209191-23-031879.hdr.sgml : 20230524
20230524160944
ACCESSION NUMBER: 0001209191-23-031879
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230522
FILED AS OF DATE: 20230524
DATE AS OF CHANGE: 20230524
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: McCray Andrew B.
CENTRAL INDEX KEY: 0001777423
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 23954215
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 27
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
X0407
4
2023-05-22
0
0001018979
AMERISAFE INC
AMSF
0001777423
McCray Andrew B.
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP-CUO
0
Common stock, par value $0.01
2023-05-22
4
S
0
978
54.42
D
8382
D
The shares were sold to pay required withholding taxes associated with the shares awarded under the related award agreement.
Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $54.37 and $54.44. The Reporting Person undertakes, upon request, to provide the SEC, the Issuer and any security holder of the Issuer, full information regarding the number of shares sold at each separate price.
Total number of shares adjusted due to immaterial miscalculation reported on May 23, 2022.
/s/Andrew B. McCray
2023-05-24