-----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, FjCv6d9hsCprwEACHgaNfnNPeBZAsTEJdsfZ20mP86hC4YdBC8LNekq9BxpSwgVE YlXn1S1JcOavWxOJR0MMww== 0001179110-09-002362.txt : 20090210 0001179110-09-002362.hdr.sgml : 20090210 20090210163622 ACCESSION NUMBER: 0001179110-09-002362 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: BARRETT WILLIAM J CENTRAL INDEX KEY: 0000923415 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 09586190 BUSINESS ADDRESS: BUSINESS PHONE: 2125100688 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: 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 0000923415 BARRETT WILLIAM J P O BOX 6199 FAIR HAVEN NJ 07704 1 1 1 0 Exec V P and Secretary Class A Common Stock 725176 D Class A Common Stock 109942 I By Spouse Class B Common Stock 743808 D Class B Common Stock 16054 I By Spouse Incentive Stock Option (reload) 6.16 2010-04-17 Class A Common Stock 27659 27659 D Incentive Stock Option 6.77 2012-06-05 Class A Common Stock 27030 27030 D Incentive Stock Option (reload) 9.03 2010-10-26 Class A Common Stock 12590 12590 D Incentive Stock Option 7.17 2013-05-03 Class A Common Stock 32436 32436 D Incentive Stock Option (reload) 6.36 2014-04-29 Class A Commmon Stock 31968 31968 D Incentive Stock Option (reload) 5.35 2015-05-07 Class A Common Stock 33641 33641 D Includes 397,838 and 41,399 shares owned by reporting persons MPPP and IRA, respectively. Reporting person disclaims benefical ownership of shares owned by wife. Includes 65,713 and 31,958 shares owned by reporting persons MPPP and IRA, respectively. Currently exercisble. Reflects adjustment for 2% and 6% stock dividends paid to all holders on August 29, 2008 and November 28, 2008, respectively William J. Barrett 2009-02-10 -----END PRIVACY-ENHANCED MESSAGE-----