-----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, Kk/AF/swwF5QLxblrXhKooTlMxciJol0bbU5rY8a0Wmqszp0FYRcXjgsGgTGs2Y0 AcH4TbT6znpprmbkek0LQw== 0000021212-04-000061.txt : 20040402 0000021212-04-000061.hdr.sgml : 20040402 20040402103956 ACCESSION NUMBER: 0000021212-04-000061 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040331 FILED AS OF DATE: 20040402 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TOMCZAK JOSEPH P CENTRAL INDEX KEY: 0001215513 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07160 FILM NUMBER: 04711731 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 4 1 tom502.xml X0201 4 2004-03-31 0 0000021212 COACHMEN INDUSTRIES INC COA 0001215513 TOMCZAK JOSEPH P P O BOX 3300 ELKHART IN 46515 0 1 0 0 Exec. VP & CFO Common Stock 2004-03-31 4 A 0 90.2784 0 A 18469.0347 D Common Stock 131.0000 I By 401(k) Stock Units 0.00 2004-03-31 4 A 0 280.8364 0 A 1988-08-08 1988-08-08 Common Stock 280.8364 3498.4045 I By Deferred Compensation Plan Restricted Stock Grant 0.00 2002-07-02 2004-07-02 Common Stock 1500.0000 1500.0000 D Stock Option (Right to Buy) 12.00 2002-08-06 2011-08-06 Common Stock 36000.0000 36000.0000 D Stock Option (Right to Buy) 16.50 2003-02-19 2012-02-19 Common Stock 5500.0000 5500.0000 D Stock Option (Right to Buy) 11.18 2004-03-28 2013-03-28 Common Stock 1600.0000 1600.0000 D Shares acquired under the Coachmen Employee Stock Purchase Plan as of March 31, 2004 quarterly purchase Based on shares reported as of April 2, 2004. 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 are payable in cash. Stock units representing amounts deferred by the reporting person are payable upon termination of employment. Direct holdings in Table I, column 5 include 10.888 shares acquired on March 30, 2004 under the Coachmen Industries, Inc. DRIP. 401(k) shares based on December 31, 2003 statement. By: Melanie A. DeMorrow as Attorney-in-fact 2004-04-02 -----END PRIVACY-ENHANCED MESSAGE-----