-----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, CzhkZ3WcMskZfTuHiIlXBr16USFsPFhKddLvHePx62BCEWQhks2m4TyMv7OEMngL Vs4BAIVQwJ/iaaisMtdpFQ== 0001179110-09-002339.txt : 20090210 0001179110-09-002339.hdr.sgml : 20090210 20090210130936 ACCESSION NUMBER: 0001179110-09-002339 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20081227 FILED AS OF DATE: 20090210 DATE AS OF CHANGE: 20090210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CANTWELL THOMAS CENTRAL INDEX KEY: 0001032277 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 09584655 BUSINESS ADDRESS: STREET 1: DISCREET LOGIC INC STREET 2: 5505 BOULEVARD ST LAURENT SUITE 5200 CITY: MONTREAL QUEBEC CANA STATE: A8 ZIP: 00000 MAIL ADDRESS: STREET 1: 1 MCGILL STREET APT#1010 CITY: MONTREAL STATE: A8 ZIP: H2Y 4A3 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 5 1 edgar.xml FORM 5 - X0303 5 2008-12-27 0 0 0 0000350846 SUPREME INDUSTRIES INC STS 0001032277 CANTWELL THOMAS #1 MCGILL STREET, APT. 1010 MONTREAL A8 H2Y 4A3 QUEBEC, CANADA 1 0 0 0 Class A Common Stock 2162 D Class A Common Stock 6243 I By the Cantwell Revocable Trust Class B Common Stock 541621 I By the Cantwell Revocable Trust Nonqualified Stock Option 6.15 2012-06-05 Class A Common Stock 6487 6487 D Holdings adjusted to reflect 2% and 6% stock dividends paid to all holders of record on August 29, 2008, and November 28, 2008, respectively. Currently exercisable. Thomas Cantwell 2009-02-10 -----END PRIVACY-ENHANCED MESSAGE-----