Filing Details

Accession Number:
0001209191-15-082075
Form Type:
4/A
Zero Holdings:
No
Publication Time:
2015-11-24 18:18:53
Reporting Period:
2015-11-02
Filing Date:
2015-11-24
Accepted Time:
2015-11-24 18:18:53
Original Submission Date:
2015-11-04
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1018979 Amerisafe Inc AMSF Fire, Marine & Casualty Insurance (6331) 752069407
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1466489 Brendan Gau 2301 Highway 190 West
Deridder LA 70634
Exec.vp & Chief Investment Of. No Yes No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock, Par Value $0.01 Acquisiton 2015-11-02 5,763 $15.60 27,119 No 4 M Direct
Common Stock, Par Value $0.01 Disposition 2015-11-02 5,763 $54.56 21,356 No 4 S Direct
Common Stock, Par Value $0.01 Acquisiton 2015-11-03 2,910 $15.60 24,266 No 4 M Direct
Common Stock, Par Value $0.01 Disposition 2015-11-03 2,910 $54.03 21,356 No 4 S Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 M Direct
No 4 S Direct
No 4 M Direct
No 4 S Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock, Par Value $0.01 Per Share Employee Stock Option (right to purchase) Disposition 2015-11-02 5,763 $0.00 5,763 $15.60
Common Stock, Par Value $0.01 Per Share Employee Stock Option (right to purchase) Disposition 2015-11-03 2,910 $0.00 2,910 $15.60
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
63,070 2010-08-07 2019-08-07 No 4 M Direct
60,160 2010-08-07 2019-08-07 No 4 M Direct
Footnotes
  1. Amendment filed to 1) correct transaction codes and 2) include the correct acquisition price of securities in Table I.
  2. Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $54.50 and $54.82. 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.
  3. Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $54.00 and $54.12. 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.
  4. The stock options became exercisable in five equal installments beginning on August 7, 2010, which was the first anniversary of the grant date.