SEC Form 4 · accession 0001209191-17-034544
AMERISAFE INC · AMSF
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Vincent J. Gagliano
Officer — EVP - Chief Risk Officer
Period of report
May 19, 2017
Accepted (ET)
May 23, 2017 · 7:28 am 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 $0.01F1 | May 19, 2017 | A | 503 | $0.00 | A | 21,662 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Shares issued for the 2014-2016 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 19, 2017 in accordance with the terms of the Plan and the related award agreement.