SEC Form 4 · accession 0001209191-15-068268
AMERISAFE INC · AMSF
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
C Allen Bradley Jr.
Officer — Executive Chairman · Director
Period of report
Aug 25, 2015
Accepted (ET)
Aug 27, 2015 · 5:34 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001018979
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $0.01 | Aug 25, 2015 | M | 54,000 | $7.50 | A | 198,862 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (right to pruchase) | $7.50 | Aug 25, 2015 | M | 54,000 | D | Nov 17, 2008 | Nov 17, 2015 | Common Stock | 54,000 | 0 | D |