-----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, FZZmmfo5M0RZF0GLK8mJw0q19fofRAgRmvB1YJQa8AJI9iFny/YUCd4en0DNY+fC C7IUq/FnqBIqrJnB3tXoCQ== 0001179110-09-002358.txt : 20090210 0001179110-09-002358.hdr.sgml : 20090210 20090210154907 ACCESSION NUMBER: 0001179110-09-002358 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: CAMPBELL ROBERT JAMES CENTRAL INDEX KEY: 0001196812 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 09585661 MAIL ADDRESS: STREET 1: JULIE GARDNER STREET 2: 15690 TREASURE COVE CITY: BULLARD STATE: TX ZIP: 25757 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 0001196812 CAMPBELL ROBERT JAMES 15690 TREASURE COVE BULLARD TX 75757 1 0 0 0 Class A Commmon Stock 89578 D Class A Common Stock 443 I By Spouse Class B Common Stock 47620 D Noqualified Stock Option 5.68 2010-04-24 Class A Common Stock 4951 4951 D Nonqualified Stock Option 6.15 2012-06-05 Class A Common Stock 6487 6487 D Nonqualified Stock Option (reload) 7.14 2011-03-05 Class A Common Stock 7385 7385 D Options adjusted to reflect adjustment for 2008 stock dividends. Reporting person disclaims beneficial ownership of shares owned by wife. Currently exercisable. Robert J. Campbell 2009-02-10 -----END PRIVACY-ENHANCED MESSAGE-----