Filing Details

Accession Number:
0001181431-11-030955
Form Type:
4
Zero Holdings:
No
Publication Time:
2011-05-19 11:37:09
Reporting Period:
2011-05-17
Filing Date:
2011-05-19
Accepted Time:
2011-05-19 11:37:09
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
1341774 R Geoffrey Banta 2301 Highway 190 West
Deridder LA 70634
President And Coo 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 $.01 Acquisiton 2011-05-17 5,000 $9.00 5,000 No 4 M Direct
Common Stock, Par Value $.01 Disposition 2011-05-17 5,000 $22.25 0 No 4 S Direct
Common Stock, Par Value $.01 Acquisiton 2011-05-18 5,000 $9.00 5,000 No 4 M Direct
Common Stock, Par Value $.01 Disposition 2011-05-18 5,000 $22.28 0 No 4 S Direct
Common Stock, Par Value $.01 Acquisiton 2011-05-19 5,000 $9.00 5,000 No 4 M Direct
Common Stock, Par Value $.01 Disposition 2011-05-19 2,500 $22.57 2,500 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
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 $.01 Employee Stock Option (right to buy) Disposition 2011-05-17 5,000 $0.00 5,000 $9.00
Common Stock Employee Stock Option (right to buy) Disposition 2011-05-18 5,000 $0.00 5,000 $9.00
Common Stock Employee Stock Option (right to buy) Disposition 2011-05-19 5,000 $0.00 5,000 $9.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
113,750 2008-11-17 2015-11-17 No 4 M Direct
108,750 2008-11-17 2015-11-17 No 4 M Direct
103,750 2008-11-17 2015-11-17 No 4 M Direct
Footnotes
  1. The price shown is a weighted average price. The shares were sold at prices ranging from $22.25 to $22.29.
  2. The price shown is a weighted average price. The shares were sold at prices ranging from $22.25 to $22.32.
  3. The price shown is a weighted average price. The shares were sold at prices ranging from $22.50 to $22.65.