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AMERISAFE INC — Director's Dealing 2006
Jan 25, 2006
32379_dirs_2006-01-25_ff3e4c92-824d-4922-93b5-fc272a165a9f.zip
Director's Dealing
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SEC Form 5 — Annual Statement of Changes in Beneficial Ownership
Issuer: AMERISAFE INC (AMSF)
CIK: 0001018979
Period of Report: 2005-12-31
Reporting Person: CARSON RUSSELL L (10% Owner)
Non-Derivative Transactions
| Date | Security | Code | Shares | Price | A/D | Holdings After | Ownership |
|---|---|---|---|---|---|---|---|
| 2005-12-14 | Common Stock | S | 432231 | $8.37 | Disposed | 7636475 | Indirect |
| 2005-12-14 | Common Stock | S | 3486 | $8.37 | Disposed | 61020 | Indirect |
Footnotes
F1: The Reporting Person is one of several general partners of the sole general partner of Welsh, Carson, Anderson & Stowe VII, L.P. and a general partner of the sole general partner of WCAS Healthcare Partners, L.P. Pursuant to Instruction 4(b)(iv) of Form 5, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein, and/or that are not actually distributed to him.
F2: The Reporting Person also directly beneficially owns 64,506 shares of Common Stock.