X0306 4 2016-05-25 0 0001018979 AMERISAFE INC AMSF 0001570960 Gagliano Vincent J. 2301 HIGHWAY 190 WEST DERIDDER LA 70634 0 1 0 0 EVP - Chief Risk Officer Common stock, par value $0.01 2016-05-25 4 A 0 469 0.00 A 23974 D Shares issued for the 2013-2015 performance period under an award agreement between the reporting person and the Company pursuant to the Company's Equity and Incentive Compensation Plan. The awards were determined by the Compensation Committee of the Board of Directors of the Company on May 25, 2016 in accordance with the terms of the Plan the related award agreement. /s/ Vincent J. Gagliano 2016-05-25