-----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, Gi1BgqXcmGaX4z89jj3ZwqAzkQhsq5ntYqe0J30mG4lx8HvM/dIvnzpjKeDO5C8v cRc8e6lz/IoIPMYPx9unHQ== 0001179110-05-020262.txt : 20051031 0001179110-05-020262.hdr.sgml : 20051031 20051031173953 ACCESSION NUMBER: 0001179110-05-020262 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051027 FILED AS OF DATE: 20051031 DATE AS OF CHANGE: 20051031 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: P O BOX 237 STREET 2: 2581 EAST KERCHER ROAD CITY: GOSHEN STATE: IN ZIP: 46528 BUSINESS PHONE: 5746423070 MAIL ADDRESS: STREET 1: P O BOX 237 STREET 2: 2581 EAST KERCHER ROAD CITY: GOSHEN STATE: IN ZIP: 46528 FORMER COMPANY: FORMER CONFORMED NAME: EXPLORATION SURVEYS INC DATE OF NAME CHANGE: 19850813 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: 051167438 BUSINESS ADDRESS: BUSINESS PHONE: 2125100684 MAIL ADDRESS: STREET 1: P O BOX 6199 CITY: FAIR HAVEN STATE: NJ ZIP: 07704 4 1 edgar.xml FORM 4 - X0202 4 2005-10-27 0 0000350846 SUPREME INDUSTRIES INC STS 0000923414 GARDNER HERBERT M P O BOX 6199 FAIR HAVEN NJ 07704 1 1 0 0 Chairman of Board/President Class A Common Stock 2005-10-27 4 M 0 33000 2.85 A 352032 D Class A Common Stock 2005-10-27 4 F 0 10604 8.87 D 341428 D Class A Common Stock 9663 I By Spouse Class B Common Stock 489322 D Class B Common Stock 56592 I By Spouse Incentive Stock Option 2.85 2005-10-27 4 M 0 33000 D 2001-11-01 2005-11-01 Class A Common Stock 33000 0 D Incentive Stock Option 5.09 2003-05-01 2007-05-01 Class A Common Stock 33000 33000 D Incentive Stock Option 4.5 2004-05-07 2008-05-07 Class A Common Stock 33000 33000 D Incentive Stock Option (Reload) 6.05 2005-04-18 5 A 0 E 23244 A 2006-04-18 2010-04-17 Class A Common Stock 23244 23244 D Incentive Stock Option 6.65 2005-06-06 5 A 0 E 25000 A 2006-06-06 2010-06-05 Class A Common Stock 25000 25000 D Incentive Stock Option (Reload) 8.87 2005-10-27 5 A 0 E 10604 A 2006-10-27 2010-10-26 Class A Common Stock 10604 10604 D Reporting person disclaims beneficial ownership of shares owned by spouse. See exercise price in Column 2. 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 exercisble after three years from date of grant. Herbert M. Gardner 2005-10-31 -----END PRIVACY-ENHANCED MESSAGE-----