-----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, A91jxJmJQ/XBmppv4sz9XiOf4Dj3FxrNlAenMMigOn3ATXLauidL7OdJ/W7j2fff iAdwbbJ5FVvWumLTmL2+0Q== 0000929966-03-000025.txt : 20031020 0000929966-03-000025.hdr.sgml : 20031020 20031020200342 ACCESSION NUMBER: 0000929966-03-000025 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: GARDNER HERBERT M CENTRAL INDEX KEY: 0000923414 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 03948686 BUSINESS ADDRESS: BUSINESS PHONE: 2125100684 MAIL ADDRESS: STREET 1: P O BOX 6199 CITY: FAIR HAVEN STATE: NJ ZIP: 07704 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 0000923414 GARDNER HERBERT M 4 DARLEY ROAD GREAT NECK NY 11021 1 1 0 0 Chairman of Board, President Class A Common Stock 2003-10-16 4 J 0 29648 5 A 326134 D Class A Common Stock 2003-10-16 4 J 0 878 5 A 9663 I By Spouse Class B Common Stock 2003-10-16 4 J 0 44484 5 A 489322 D Class B Common Stock 2003-10-16 4 J 0 5145 5 A 56592 I By spouse Stock Option 6.5 2003-10-16 4 J 0 3038 217262 A 1999-10-28 2003-10-28 Class A Common 33425 33425 D Stock Option 4.87 2003-10-16 4 J 0 2625 140625 A 2001-04-27 2005-04-27 Class A Common 28875 28875 D Stock Option 2.85 2003-10-16 4 J 0 3000 94050 A 2001-11-01 2005-11-01 Class A Common 33000 33000 D Stock Option 5.09 2003-10-16 4 J 0 3000 167970 A 2003-05-01 2007-05-01 Class A Common 33000 33000 D Stock Option 4.5 2003-10-16 4 J 0 3000 148500 A 2004-05-07 2008-05-07 Class A Common 33000 33000 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. Reporting Person disclaims beneficial ownership of shares owned by spouse. 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 Includes 170,819 Class A Common shares owned by Mr. Gardner's qualified plan and 12,733 Class A Common shares owned by The Gardner Family Foundation, Inc., of which Mr. Gardner is President. Herbert M. Gardner 2003-10-20 -----END PRIVACY-ENHANCED MESSAGE-----