-----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, IyTDxzc+fqkHwJPqdZ/tmWwlh6AbAq7Uo1t8WrabZSd789EpORxlNf8qz1KCKZsj PS8U5+gayhgELWH9KNcXhg== 0000021212-04-000131.txt : 20041001 0000021212-04-000131.hdr.sgml : 20041001 20041001184253 ACCESSION NUMBER: 0000021212-04-000131 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040930 FILED AS OF DATE: 20041001 DATE AS OF CHANGE: 20041001 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: 041059940 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 sch551.xml X0202 4 2004-09-30 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 2004-09-30 4 A 0 121.4434 0 A 1988-08-08 1988-08-08 Common Stock 121.4434 325.4970 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 October 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: By: Melanie A. DeMorrow as Attorney-in-fact for: 2004-10-01 -----END PRIVACY-ENHANCED MESSAGE-----