AMERISAFE INC — Director's Dealing 2013

Dec 13, 2013

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: AMERISAFE INC (AMSF)
CIK: 0001018979
Period of Report: 2013-12-11

Reporting Person: BANTA GEOFFREY R (EVP/Corporate Development)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2013-12-11	Common Stock, par value $0.01	M	1803	$9	Acquired	13293	Direct
2013-12-11	Common Stock, par value $0.01	S	1803	$40.69	Disposed	11490	Direct
2013-12-12	Common Stock, par value $0.01	M	5697	$9	Acquired	17187	Direct
2013-12-12	Common Stock, par value $0.01	S	5697	$40.63	Disposed	11490	Direct

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2013-12-11	Employee Stock Option (right to purchase)	$9	M	1803	Disposed	2015-11-17	Common Stock (1803)	Direct
2013-12-12	Employee Stock Option (right to purchase)	$9	M	5697	Disposed	2015-11-17	Common Stock (5697)	Direct

Footnotes

F1: Represents the weighted average selling price of the Issuer's common stock. The range of the sales prices were between $40.67 and $40.80. 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.

F2: Represents the weighted average selling price of the Issuer's common stock. The range of the sales prices were between $40.55 and $40.75. 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.