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AMERISAFE INC Director's Dealing 2018

May 22, 2018

32379_dirs_2018-05-22_b9ebcff5-cc38-4e6c-90b8-b6a077cad86b.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: 2018-05-18

Reporting Person: Frost G. Janelle (Director, President & CEO)

Non-Derivative Transactions

Date Security Code Shares Price A/D Holdings After Ownership
2018-05-18 Common Stock, par value $0.01 A 1510 $0.00 Acquired 61911 Direct
2018-05-22 Common Stock, par value $0.01 S 685 $60.10 Disposed 61226 Direct

Footnotes

F1: Shares 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.

F2: The shares were sold pursuant to the Reporting Person's 10b5-1 plan to pay required withholding taxes associated with shares of stock associated with 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.

F3: Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $60.05 and $60.10. 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.