-----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, REXf43AGlRLFGS5pFGv39NSAtuA1NO1nZPhvqLuVg1wAOS3QVA/3M83NXbOe4w42 uu9uiCeegnb7yGDPmg/d6Q== 0000021212-09-000027.txt : 20090107 0000021212-09-000027.hdr.sgml : 20090107 20090107171634 ACCESSION NUMBER: 0000021212-09-000027 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20081219 FILED AS OF DATE: 20090107 DATE AS OF CHANGE: 20090107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAVERS RICHARD M CENTRAL INDEX KEY: 0001215511 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-07160 FILM NUMBER: 09513859 BUSINESS ADDRESS: BUSINESS PHONE: 5748255821 MAIL ADDRESS: STREET 1: P O BOX 30 CITY: MIDDLEBURY STATE: IN ZIP: 46540 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: PO BOX 30 STREET 2: 423 N MAIN STREET CITY: MIDDLEBURY STATE: IN ZIP: 46540 BUSINESS PHONE: 5748255821 MAIL ADDRESS: STREET 1: PO BOX 30 STREET 2: 423 N MAIN STREET CITY: MIDDLEBURY STATE: IN ZIP: 46540 4/A 1 lav867.xml X0303 4/A 2008-12-19 2008-12-23 0 0000021212 COACHMEN INDUSTRIES INC COA 0001215511 LAVERS RICHARD M PO BOX 3300 ELKHART IN 46515 0 1 0 0 Chief Executive Officer Common Stock 71078.9688 D Common Stock 297.8563 I By 401(k) Stock Units 2008-12-19 4 I 0 40895.2482 0 D 1988-08-08 1988-08-08 Common Stock 40895.2482 18632.0143 I By Deferred Compensation Plan Stock Option (Right to Buy) 10.0000 2001-10-06 2010-10-06 Common Stock 36000.0000 36000.0000 D Stock Option (Right to Buy) 16.5000 2003-02-19 2012-02-19 Common Stock 5500.0000 5500.0000 D Stock Option (Right to Buy) 11.1800 2004-03-28 2013-03-28 Common Stock 1600.0000 1600.0000 D 1-for-1 Each stock unit is equivalent of one share of COA common stock. Shares are payable in cash following the reporting person's termination of employment, and may be transferred by the reporting person into an alternative investment account at any time. By: By: Melanie A. DeMorrow as Attorney-in-fact for: 2009-01-07 -----END PRIVACY-ENHANCED MESSAGE-----