-----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, LqJgzszcsqeW/7bj9e7AOSQw3uO4AvWEa4VW9kAp6xJFkN1UDz3oBdBG41n1AQb6 ROjygFKaNBl7xof9/VJMrw== 0001179110-10-014820.txt : 20101007 0001179110-10-014820.hdr.sgml : 20101007 20101007180438 ACCESSION NUMBER: 0001179110-10-014820 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101001 FILED AS OF DATE: 20101007 DATE AS OF CHANGE: 20101007 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mowery Jeffery D CENTRAL INDEX KEY: 0001402452 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 101114726 MAIL ADDRESS: STREET 1: 2581 E. KERCHER ROAD CITY: GOSHEN STATE: IN ZIP: 46528 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/A 1 edgar.xml FORM 4/A - X0303 4/A 2010-10-01 2010-10-05 0 0000350846 SUPREME INDUSTRIES INC STS 0001402452 Mowery Jeffery D 2581 E KERCHER ROAD GOSHEN IN 46528 0 1 0 0 Treasurer VP-Finance Incentive Stock Option 1.55 2010-06-26 2016-06-25 Class A Common Stock 12000 12000 D Incentive Stock Option 2.23 2010-10-01 4 A 0 20000 A 2011-10-01 2017-09-30 Class A Common Stock 20000 20000 D Amended to reflect the title of derivative security as Incentive Stock Option in Table II, column 1. Stock options are exercisable as follows: 33% exercisable after one year from date of grant; additional 33% after two years from date of grant; and remaining 34% exercisable three years from date of grant. Not applicable. Jeffery D. Mowery 2010-10-07 -----END PRIVACY-ENHANCED MESSAGE-----