0001179110-13-001928.txt : 20130205
0001179110-13-001928.hdr.sgml : 20130205
20130205164853
ACCESSION NUMBER: 0001179110-13-001928
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121229
FILED AS OF DATE: 20130205
DATE AS OF CHANGE: 20130205
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BARRETT WILLIAM J
CENTRAL INDEX KEY: 0000923415
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-08183
FILM NUMBER: 13574665
MAIL ADDRESS:
STREET 1: P O BOX 6199
CITY: FAIR HAVEN
STATE: NJ
ZIP: 07704
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
5
1
edgar.xml
FORM 5 -
X0306
5
2012-12-29
0
0
0
0000350846
SUPREME INDUSTRIES INC
STS
0000923415
BARRETT WILLIAM J
P O BOX 6199
FAIR HAVEN
NJ
07704
1
1
1
0
Exec V P and Secretary
Class A Common Stock
2012-12-24
5
J
0
170000
D
555176
D
Class A Common Stock
170000
I
By Grantor Trust
Class A Common Stock
109942
I
By Spouse
Class B Common Stock
843808
D
Class B Common Stock
16054
I
By Spouse
Incentive Stock Option
7.17
2013-05-03
Class A Common Stock
32436
32436
D
Incentive Stock Option (reload)
6.36
2014-04-29
Class A Commmon Stock
31968
31968
D
Incentive Stock Option (reload)
5.34
2015-05-07
Class A Common Stock
33641
33641
D
Incentive Stock Option
1.71
2016-06-25
Class A Common Stock
15000
15000
D
Incentive Stock Option
2.45
2017-09-30
Class A Common Stock
30000
30000
D
Reporting person disclaims benefical ownership of shares owned by wife.
Currently exercisble.
Not applicable.
On December 24, 2012, reporting person contributed 170,000 shares of STS Class A Common Stock which is owned by a grantor trust of which the reporting person is the trustee and of which the reporting person and spouse are beneficiaries. The reporting person continues to report beneficial ownership of all STS Class A Common Stock held by the grantor trust, but disclaims beneficial ownership except to the extent of his and his spouse's pecuniary interest therein.
William J. Barrett
2013-02-05