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Documents Incorporated by Reference in ‘RW’ Filing 950134-96-5799 · Filed re: Wednesday, 11/6/96
6
’NOV’


        

2  Filings
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  As Of               Filer                 Filing¹   For·On·As Docs:Size             Issuer                      Filing Agent      
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 11/6/96  Amerisafe Inc.                    15-12G                 1:3K                                     RR Donnelley             
 11/6/96  Amerisafe Inc.                    RW                     1:5K                                     RR Donnelley             
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 ¹  Filing/Form Types: 
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  15-12G    Certification of a Termination of Registration of a Class of Securities — Form 15.
  RW    Registration Withdrawal Request.

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