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AMERISAFE INC Director's Dealing 2015

Nov 9, 2015

32379_dirs_2015-11-09_717b98de-8535-4a6b-a57a-dea47b8f03b1.zip

Director's Dealing

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SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: AMERISAFE INC (AMSF)
CIK: 0001018979
Period of Report: 2015-11-05

Reporting Person: Gau Brendan (Exec.VP & Chief Investment Of.)

Non-Derivative Transactions

Date Security Code Shares Price A/D Holdings After Ownership
2015-11-05 Common Stock, par value $0.01 A 14481 $0.00 Acquired 35837 Direct
2015-11-05 Common Stock, par value $0.01 D 14481 $54.00 Disposed 21356 Direct
2015-11-06 Common Stock, par value $0.01 A 10967 $0.00 Acquired 32323 Direct
2015-11-06 Common Stock, par value $0.01 D 10967 $54.01 Disposed 21356 Direct

Derivative Transactions

Date Security Exercise Price Code Shares A/D Expiration Underlying Ownership
2015-11-05 Employee Stock Option (right to purchase) $15.60 S 160 Disposed 2019-08-07 Common stock, par value $0.01 per share (160) Direct
2015-11-05 Employee Stock Option (right to purchase) $15.60 S 14321 Disposed 2019-08-07 Common stock, par value $0.01 per share (14321) Direct
2015-11-06 Employee Stock Option (right to purchase) $15.60 S 679 Disposed 2019-08-07 Common stock, par value $0.01 per share (679) Direct
2015-11-06 Employee Stock Option (right to purchase) $15.60 S 10288 Disposed 2019-08-07 Common stock, par value $0.01 per share (10288) Direct

Footnotes

F1: Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $54.00 and $54.07. 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 sales prices were between $54.00 and $54.03. 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.