AMERISAFE INC — Director's Dealing 2016

May 12, 2016

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: AMERISAFE INC (AMSF)
CIK: 0001018979
Period of Report: 2016-05-10

Reporting Person: Gagliano Vincent J. (EVP - Chief Risk Officer)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2016-05-10	Common stock, par value $0.01	M	1092	$14.20	Acquired	24597	Direct
2016-05-10	Common stock, par value $0.01	S	1092	$57.06	Disposed	23505	Direct
2016-05-11	Common stock, par value $0.01	M	2108	$14.20	Acquired	25613	Direct
2016-05-11	Common stock, par value $0.01	S	2108	$57.17	Disposed	23505	Direct

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2016-05-10	Employee Stock Option (right to purchase)	$14.20	M	600	Disposed	2019-11-09	Common stock (600)	Direct
2016-05-10	Employee Stock Option (right to purchase)	$14.20	M	492	Disposed	2019-11-09	Common stock (492)	Direct
2016-05-10	Employee Stock Option (right to purchase)	$14.20	M	2108	Disposed	2019-11-09	Common stock (2108)	Direct

Footnotes

F1: Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $57.00 and $57.20. 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 $57.00 and $57.24. 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.

F3: Represents stock options that become exercisable in five equal installments beginning on November 9, 2010, which was the first anniversary of the grant date. The options were exercised and sold pursuant to the Reporting Person's 10b5-1 plan.