-----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, I28ukARaF48hWn7wiODhhgUjQgssh1HjSeg1zOv0ugu/VgbHxRnlIgxEjwvpuKNe JLyJDrdABXnljzfFGfo43g== 0001140361-10-000392.txt : 20100105 0001140361-10-000392.hdr.sgml : 20100105 20100105123726 ACCESSION NUMBER: 0001140361-10-000392 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100104 FILED AS OF DATE: 20100105 DATE AS OF CHANGE: 20100105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAVERS RICHARD M CENTRAL INDEX KEY: 0001215511 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07160 FILM NUMBER: 10505310 MAIL ADDRESS: STREET 1: P O BOX 3300 CITY: ELKHART STATE: IN ZIP: 46515 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: 1027 BUSINESS ADDRESS: STREET 1: PO BOX 3300 STREET 2: 2831 DEXTER DRIVE CITY: ELKHART STATE: IN ZIP: 46515 BUSINESS PHONE: 574-266-2500 MAIL ADDRESS: STREET 1: PO BOX 3300 STREET 2: 2831 DEXTER DRIVE CITY: ELKHART STATE: IN ZIP: 46515 4 1 doc1.xml FORM 4 X0303 4 2010-01-04 0 0000021212 COACHMEN INDUSTRIES INC COHM.PK 0001215511 LAVERS RICHARD M PO BOX 3300 ELKHART IN 46515 0 1 0 0 President & CEO COMMON STOCK 292.3718 I By 401(k) COMMON STOCK 2010-01-04 4 F 0 704 1.15 D 76636.4436 D STOCK OPTION (RIGHT TO BUY) 10.00 2001-10-06 2010-10-06 COMMON STOCK 36000 36000 D STOCK OPTION (RIGHT TO BUY) 16.50 2003-02-19 2012-02-19 COMMON STOCK 5500 5500 D STOCK OPTION (RIGHT TO BUY) 11.18 2004-03-28 2013-03-28 COMMON STOCK 1600 1600 D 401(k) holdings based on current quarter end statement. By: Melanie A. DeMorrow as Attorney-in-fact for: Richard M. Lavers 2010-01-05 -----END PRIVACY-ENHANCED MESSAGE-----