0001179110-11-007602.txt : 20110509 0001179110-11-007602.hdr.sgml : 20110509 20110509142948 ACCESSION NUMBER: 0001179110-11-007602 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110505 FILED AS OF DATE: 20110509 DATE AS OF CHANGE: 20110509 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CAMPBELL ROBERT JAMES CENTRAL INDEX KEY: 0001196812 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 11822730 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: 1225 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 2011-05-05 0 0000350846 SUPREME INDUSTRIES INC STS 0001196812 CAMPBELL ROBERT JAMES 15690 TREASURE COVE BULLARD TX 75757 1 0 0 0 Class A Common Stock 2011-05-05 4 A 0 3846 A 99868 D Class A Common Stock 443 I By Spouse Class B Common Stock 47620 D Non-Statutory Stock Option 6.15 2012-06-05 Class A Common 6487 6487 D Reporting Person disclaims beneficial ownership of shares owned by Spouse. Currently exercisable. Not applicable -- stock grant. Robert J. Campbell 2011-05-09