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