-----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, CD8bkxI5QVPK/Dhm+esTpPsNdaM24DB/4zs1dtGdLncuvCalDCpTYkwSY/mZlwGR WQxQzOnDXDKX+5akg9mmoA== 0001179110-09-012630.txt : 20090827 0001179110-09-012630.hdr.sgml : 20090827 20090827171655 ACCESSION NUMBER: 0001179110-09-012630 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090825 FILED AS OF DATE: 20090827 DATE AS OF CHANGE: 20090827 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NEILSON MARK C CENTRAL INDEX KEY: 0001251089 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 091040450 MAIL ADDRESS: STREET 1: 1361 BRIDGEWATER WAY CITY: MISHAWAKA STATE: IN ZIP: 46545 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 4 1 edgar.xml FORM 4 - X0303 4 2009-08-25 0 0000350846 SUPREME INDUSTRIES INC STS 0001251089 NEILSON MARK C 7140 CALABRIA COURT SAN DIEGO CA 92122 1 0 0 0 Class A Common Stock 2009-08-25 4 A 0 8353 2.98 A 90577 D Non-Statutory Stock Option 6.15 2012-06-05 Class A Common Stock 6487 6487 D Nonqualified Stock Option (reload) 4.86 2013-05-07 Class A Common Stock 5097 5097 D Includes 35,142 shares owned by Reporting Persons IRA The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $2.89 to $3.04, inclusive. The reporting person undertakes to provide Supreme Industries, Inc., any security holder of Supreme Industries, Inc., or the staff of the SEC, upon request, full information regarding the number of shares purchased at each separate price within the ranges set forth in footnote (2) to this Form 4. Currently exercisable. Option vests 33% after one year from date of grant ("May 8, 2008"); additional 33% two years from date of grant; and the remaining 34% three years from date of grant. Mark C. Neilson 2009-08-27 -----END PRIVACY-ENHANCED MESSAGE-----