-----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, KTFqUTHUU+5GwOWxAdvkelbSv+jTawGa2qxeqjojUB/qPs+90KMcR4KJQINJ6gCD cqRrjK64v9tJuMTaeZVHAQ== 0000021212-04-000017.txt : 20040116 0000021212-04-000017.hdr.sgml : 20040116 20040116135028 ACCESSION NUMBER: 0000021212-04-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040115 FILED AS OF DATE: 20040116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MARTINI THOMAS J CENTRAL INDEX KEY: 0001216775 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07160 FILM NUMBER: 04529308 BUSINESS ADDRESS: STREET 1: PO BOX 3300 CITY: ELKHART STATE: IN ZIP: 46515-3300 MAIL ADDRESS: STREET 1: PO BOX 3300 CITY: ELKHART STATE: IN ZIP: 46515-3300 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 DRIVE CITY: ELKHART STATE: IN ZIP: 46514 BUSINESS PHONE: 5742620123 MAIL ADDRESS: STREET 1: PO BOX 3300 STREET 2: 2831 DEXTER DRIVE CITY: ELKHART STATE: IN ZIP: 46515 4 1 mar484.xml X0201 4 2004-01-15 1 0000021212 COACHMEN INDUSTRIES INC COA 0001216775 MARTINI THOMAS J P O BOX 3300 ELKHART IN 46515 0 0 0 1 Former VP & Treasurer Common Stock 2004-01-15 4 M 0 750 7.88 A 13328.6240 D Common Stock 2004-01-15 4 M 0 500 12.00 A 13828.6240 D Common Stock 2004-01-15 4 M 0 500 16.50 A 14328.6240 D Common Stock 2004-01-15 4 F 0 1019 19.78 D 13309.6240 D Common Stock 129.0000 I By 401(k) Stock Option (Right to Buy) 7.88 2004-01-15 4 M 0 750 0 D 2001-10-31 2010-10-31 Common Stock 750.0000 250.0000 D Stock Option (Right to Buy) 12.00 2004-01-15 4 M 0 500 0 D 2002-08-06 2011-08-06 Common Stock 500.0000 500.0000 D Stock Option (Right to Buy) 16.50 2004-01-15 4 M 0 500 0 D 2003-02-19 2012-02-19 Common Stock 500.0000 1500.0000 D Stock Option (Right to Buy) 11.18 2004-03-28 2013-03-28 Common Stock 500.0000 500.0000 D Stock Units 0.00 1988-08-08 1988-08-08 Common Stock 39.5176 39.5176 I By Deferred Compensation Plan COA common stock exchanged for exercise of stock option 401(k) shares based on holdings as of December 31, 2003 statement. By: Melanie A. DeMorrow as Attorney-in-fact 2004-01-16 -----END PRIVACY-ENHANCED MESSAGE-----