-----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, Ptq0e5vPh5aENJXOvggGWzTQbbtHfzi52xxdTXN1oRsGjyooUFmoth29p160UT9x U+tql47x08hyeeVb3sYxUw== 0000929966-03-000024.txt : 20031020 0000929966-03-000024.hdr.sgml : 20031020 20031020192758 ACCESSION NUMBER: 0000929966-03-000024 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031016 FILED AS OF DATE: 20031020 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCHROCK HAROLD DOUGLAS CENTRAL INDEX KEY: 0001251090 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 03948653 MAIL ADDRESS: STREET 1: 631 EAST NORTHSHORE DRIVE CITY: SYRACUSE STATE: IN ZIP: 46567 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SUPREME INDUSTRIES INC CENTRAL INDEX KEY: 0000350846 STANDARD INDUSTRIAL CLASSIFICATION: TRUCK & BUS BODIES [3713] IRS NUMBER: 751670945 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 65140 US 33 E STREET 2: PO BOX 237 CITY: GOSHEN STATE: IN ZIP: 46526 BUSINESS PHONE: 2196423070 MAIL ADDRESS: STREET 1: P O BOX 237 STREET 2: 65140 U S 33 EAST CITY: GOSHEN STATE: IN ZIP: 46526 FORMER COMPANY: FORMER CONFORMED NAME: EXPLORATION SURVEYS INC DATE OF NAME CHANGE: 19850813 4 1 primary_doc.xml PRIMARY DOCUMENT X0201 4 2003-10-16 0 0000350846 SUPREME INDUSTRIES INC sts 0001251090 SCHROCK HAROLD DOUGLAS 631 EAST NORTHSHORE DRIVE SYRACUSE IN 46567 1 0 0 0 Class A Common Stock 2003-10-16 4 J 0 7132 5 A 78456 D Stock Option 6.5 2003-10-16 4 J 0 303 21710 A 1999-10-28 2003-10-28 Class A Common 3340 3340 D Stock Option 4.87 2003-10-16 4 J 0 525 28125 A 2001-04-27 2005-04-27 Class A Common 5775 5775 D Stock Option 5.09 2003-10-16 4 J 0 500 27995 A 2003-05-01 2007-05-01 Class A Common 5500 5500 D Stock Option 4.5 2003-10-16 4 J 0 500 24750 A 2004-05-07 2008-05-07 Class A Common 5500 5500 D On September 24, 2003, STS declared a 10% stock dividend payable to all holders of record of Class A and Class B Common Stock as of October 6, 2003, payable October 16, 2003. The stock options are exercisable, as follows: one-third exercisable after one year from date of grant; two-thirds exercisable after two years from date of grant; and all exercisable after three years from date of grant. H. Douglas Schrock 2003-10-20 -----END PRIVACY-ENHANCED MESSAGE-----