0001179110-12-015817.txt : 20121108
0001179110-12-015817.hdr.sgml : 20121108
20121108160522
ACCESSION NUMBER: 0001179110-12-015817
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121107
FILED AS OF DATE: 20121108
DATE AS OF CHANGE: 20121108
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: 121190092
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 -
X0306
4
2012-11-07
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
2012-11-07
4
A
0
5000
3.6245
A
103867
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 40,142 shares owned by Reporting Persons IRA
Currently exercisable.
The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $3.619 to $3.63, inclusive. The reporting person undertakes to provide Supreme Industries, Inc., any security holder of Supreme, 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 this footnote.
Mark C. Neilson
2012-11-08