UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 8-K
CURRENT REPORT
Pursuant to Section 13 or 15(d) of the
Securities Exchange Act of 1934
Date of report (Date of earliest event reported): February 23, 2007
AMERISAFE, INC.
(Exact Name of Registrant as Specified in Charter)
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Texas
(State or Other Jurisdiction
of Incorporation)
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000-51520
(Commission
File Number)
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75-2069407
(IRS Employer
Identification No.) |
2301 Highway 190 West
DeRidder, Louisiana 70634
(Address of Principal Executive Offices) (Zip Code)
Registrants telephone number, including area code: (337) 463-9052
Check the appropriate box below if the Form 8-K filing is intended to simultaneously
satisfy the filing obligation of the Registrant under any of the following provisions (see
General Instruction A.2. below):
¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
¨ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR
240.14a-12)
¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17
CFR 240.14d-2(b))
¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17
CFR 240.13e-4(c))
Item 5.02. Departure of Directors or Certain Officers; Election of Directors; Appointment of
Certain Officers; Compensatory Arrangements of Certain Officers.
On February 23, 2007, Paul B. Queally notified AMERISAFE, Inc. (the Company) of his
resignation from the Companys Board of Directors effective on March 1, 2007.
At a meeting held on February 27, 2007, the Companys Board of Directors elected Randy Roach
to fill the vacancy created by Mr. Queallys resignation. Mr. Roachs term will expire at the
Companys Annual Meeting of Shareholders in 2009. Mr. Roach is the currently serving Mayor of Lake
Charles, Louisiana, and is a former member of the House of Representatives of the Louisiana
Legislature.
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly
caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
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AMERISAFE, INC.
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By: |
/s/ Todd Walker
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Todd Walker, Executive Vice President, |
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General Counsel and Secretary |
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Date: February 28, 2007