-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, L4OEUpFrCNBgK188qDQgvJQp+ZPj77obqi7Ksd9NvYRbl3FvEvcm5fLPMNifvXKW 0pS8n6hFwxPapEe/1fN2Cw== 0000021212-03-000064.txt : 20031001 0000021212-03-000064.hdr.sgml : 20031001 20031001170606 ACCESSION NUMBER: 0000021212-03-000064 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030930 FILED AS OF DATE: 20031001 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SKINNER CLAIRE C CENTRAL INDEX KEY: 0001215515 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07160 FILM NUMBER: 03921401 BUSINESS ADDRESS: STREET 1: P O BOX 3300 CITY: ELKHART STATE: IN ZIP: 465153300 MAIL ADDRESS: STREET 1: P O BOX 3300 CITY: ELKHART STATE: IN ZIP: 465153300 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: COACHMEN INDUSTRIES INC CENTRAL INDEX KEY: 0000021212 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR HOMES [3716] IRS NUMBER: 351101097 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2831 DEXTER DR CITY: ELKHART STATE: IN ZIP: 46514 BUSINESS PHONE: 2192620123 MAIL ADDRESS: STREET 1: 2831 DEXTER DR CITY: ELKHART STATE: IN ZIP: 46514 4 1 ski456.xml X0201 4 2003-09-30 0 0000021212 COACHMEN INDUSTRIES INC COA 0001215515 SKINNER CLAIRE C P O BOX 3300 ELKHART IN 46515 1 1 0 0 Chairman, CEO & President Common Stock 200791.0000 D Common Stock 234.0000 I By 401(k) Common Stock 40642.0000 I By Spouse Common Stock 120.0000 I By Spouse 401(k) Stock Option (Right to Buy) 24.88 2000-01-28 2004-01-28 Common Stock 10000.0000 10000.0000 D Stock Option (Right to Buy) 10.00 2001-10-06 2010-10-06 Common Stock 50000.0000 50000.0000 D Stock Option (Right to Buy) 16.50 2003-02-19 2012-02-19 Common Stock 8000.0000 8000.0000 D Stock Option (Right to Buy) 11.18 2004-03-28 2013-03-28 Common Stock 2000.0000 2000.0000 D Stock Units 0.00 2003-09-30 4 A 0 284.4603 0 A 1988-08-08 1988-08-08 Common Stock 284.4603 3457.5025 I By Deferred Compensation Plan Stock Units 0.00 2003-09-30 4 A 0 5.7234 0 A 1988-08-08 1988-08-08 Common Stock 5.7234 1122.7723 I By Spouse Deferred Compensation Plan Based on shares reported as of October 1, 2003. The stock units represent amounts deferred and employer matching contributions accrued under the Coachmen Industries, Inc. Deferred Compensation Plan. Stock units representing employer matching contributions vest in 5 years (subject to acceleration upon certain events) and are payable following the termination of employment or a change in control, subject to forfetiture if certain post-employment covenants are breached. Stock units representing 50% of the employer matching contributions are payable in common stock (subject to certain diversification rights) and the remainder of stock units are payable in common stock or cash at the reporting person's election. Stock units representing amounts deferred by the reporting person are payable upon termination of employment. 401(k) shares based on September 30, 2003 statement By: Melanie A. DeMorrow as Attorney-in-fact 2003-10-01 -----END PRIVACY-ENHANCED MESSAGE-----