SEC Form 4 · accession 0001209191-18-032375
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 18, 2018
Accepted (ET)
May 22, 2018 · 5:39 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 $0.01F1 | May 18, 2018 | A | 498 | $0.00 | A | 17,178 | D | |
| Common stock, par value $0.01F2,F3 | May 22, 2018 | S | 249 | $60.15 | D | 16,929 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Shares issued for the 2015-2017 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 18, 2018 in accordance with the terms of the Plan and the related award agreement.
- F2The shares were sold pursuant to the Reporting Person's 10b5-1 plan for shares of stock awarded for the 2015-2017 performance period in accordance with the terms of the Plan and the related award agreement.
- F3Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $60.10 and $60.15. 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.