0001179110-12-018229.txt : 20121226 0001179110-12-018229.hdr.sgml : 20121226 20121226185427 ACCESSION NUMBER: 0001179110-12-018229 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121221 FILED AS OF DATE: 20121226 DATE AS OF CHANGE: 20121226 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gajarsa Arthur J CENTRAL INDEX KEY: 0001553894 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 121286034 MAIL ADDRESS: STREET 1: P O BOX 226 CITY: HOLDERNESS STATE: NH ZIP: 03245 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 2012-12-21 0 0000350846 SUPREME INDUSTRIES INC STS 0001553894 Gajarsa Arthur J P O BOX 226 HOLDERNESS NH 03245 1 0 0 0 Class A Common Stock 2012-12-21 4 A 0 3873 A 10873 D Not applicable - stock grant. Arthur J. Gajarsa 2012-12-26