-----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, Dm+CUqESdew4d3QHx3q7pr2H01Gd8l+ooC+RFr4vtV7eydVEQZDmNIzP5afPCrcC XCltJgdoOMak6sLSDW1Q7A== 0000021212-04-000083.txt : 20040701 0000021212-04-000083.hdr.sgml : 20040701 20040701130101 ACCESSION NUMBER: 0000021212-04-000083 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20040630 FILED AS OF DATE: 20040701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCHAFER MATTHEW J CENTRAL INDEX KEY: 0001270954 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07160 FILM NUMBER: 04894112 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 sch528.xml X0202 4 2004-06-30 0 0000021212 COACHMEN INDUSTRIES INC COA 0001270954 SCHAFER MATTHEW J P O BOX 3300 ELKHART IN 46515 0 1 0 0 President & COO Common Stock 12000.0000 D Stock Units 0.000 2004-06-30 4 A 0 117.5848 0 A 1988-08-08 1988-08-08 Common Stock 117.5848 204.0536 I By Deferred Compensation Plan Restricted Stock Grant 0.000 2004-12-01 2008-12-01 Common Stock 7000.0000 7000.0000 D Stock Option (Right to Buy) 17.400 2004-12-01 2013-12-01 Common Stock 5000.0000 5000.0000 D Based on shares reported as of July 1, 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. By: Melanie A. DeMorrow as Attorney-in-fact for: 2004-07-01 EX-24 2 powerofattorneyms6-04.txt POWEROFATTORNEY Power of Attorney Know all by these presents, that the undersigned (the "Reporting Person") hereby constitutes and appoints each of Melanie A. DeMorrow, Assistant Vice President-Shareholder Relations; Richard M. Lavers, Secretary; Joseph P. Tomczak, Executive Vice President & C.F.O.; Kathy Samovitz, Associate Counsel; and Jessica L. Long, Assistant Secretary, signing singly, as the Reporting Person's true and lawful attorney-in-fact, to: (1) execute for and on behalf of the Reporting Person, in the Reporting Person's capacity as an officer or trustee of Coachmen Industries, Inc. (the "Company"), Forms 3, 4, and 5 and such other similar forms as may be required for filing in accordance with Section 16(a) of the Securities Exchange Act of 1934, or the Sarbanes-Oxley Act of 2002, and the rules thereunder; (2) do and perform all acts for and on behalf of the Reporting Person which may be necessary or desirable to complete and execute any such forms and timely file such forms with the United States Securities and Exchange Commission and any stock exchange or similar authority or other federal agency; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, and in the best interest of, or legally required by, the Reporting Person. The Reporting Person hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the Reporting Person might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-facts substitute or substitutes, shall lawfully do or cause to be done by the virtue of this Power of Attorney and the rights and powers herein granted. The Reporting Person acknowledges that the foregoing attorneys-in fact, in serving in such capacity at the request of the Reporting Person, are not assuming, nor is the company assuming, any of the Reporting Persons responsibilities to comply with any of the above specified laws or regulations. This Power of Attorney shall remain in full force and effect until the Reporting Person is no longer required to file such forms with respect to the Reporting Person's holdings of and transactions in securities issued by the Company, unless earlier revoked by the Reporting Person in a signed writing delivered to the Secretary of the Company. IN WITNESS WHEREOF, the Reporting Person has caused this Power of Attorney to be executed as of this 14th day of June, 2004. s/Matthew J. Schafer -----END PRIVACY-ENHANCED MESSAGE-----