-----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, NAOQT5ZoUmj6K2GrIQ7nHwJ9iFuwYjWzJ30qxNoY9BWpnzt/JZzEw5wquowLn0U7 VQJLVzSziegtzyq3oUrWmg== 0000021212-05-000021.txt : 20050204 0000021212-05-000021.hdr.sgml : 20050204 20050204171226 ACCESSION NUMBER: 0000021212-05-000021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050203 FILED AS OF DATE: 20050204 DATE AS OF CHANGE: 20050204 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: 05577999 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 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 tom569.xml X0202 4 2005-02-03 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 2005-02-03 2005-02-04 4 I 0 28.783 14.980 A 223.7830 I By 401(k) Common Stock 20274.4275 D Stock Option (Right to Buy) 12.000 2002-08-06 2011-08-06 Common Stock 36000.0000 36000.0000 D Stock Option (Right to Buy) 16.500 2003-02-19 2012-02-19 Common Stock 5500.0000 5500.0000 D Stock Option (Right to Buy) 11.180 2004-03-28 2013-03-28 Common Stock 1600.0000 1600.0000 D Stock Units 0.000 1988-08-08 1988-08-08 Common Stock 4412.2859 4412.2859 I By Deferred Compensation Plan 401(k) holdings include 9 shares acquired under the plan since the date of the reporting person's last statement. By: By: Melanie A. DeMorrow as Attorney-in-fact for: 2005-02-04 -----END PRIVACY-ENHANCED MESSAGE-----