0001179110-16-025373.txt : 20160523
0001179110-16-025373.hdr.sgml : 20160523
20160523172454
ACCESSION NUMBER: 0001179110-16-025373
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160520
FILED AS OF DATE: 20160523
DATE AS OF CHANGE: 20160523
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GARDNER HERBERT M
CENTRAL INDEX KEY: 0000923414
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-08183
FILM NUMBER: 161670121
MAIL ADDRESS:
STREET 1: P O BOX 6199
CITY: FAIR HAVEN
STATE: NJ
ZIP: 07704
4
1
edgar.xml
FORM 4 -
X0306
4
2016-05-20
0
0000350846
SUPREME INDUSTRIES INC
STS
0000923414
GARDNER HERBERT M
P O BOX 463
WADING RIVER
NY
11792
1
1
0
0
Chairman of Board
Class A Common Stock
2016-05-20
4
S
0
452
13.01
D
422969
D
Class A Common Stock
10969
I
By GST U/W/O Mary K. Gardner
Class B Common Stock
587862
D
Class B Common Stock
66516
I
By GST U/W/O Mary K. Gardner
Incentive Stock Option
2.12
2017-09-30
Class A Common Stock
31500
31500
D
Reporting Person disclaims beneficial ownership of shares owned by the Generation Skipping Marital Trust U/W/O Mary K. Gardner, of which the Reporting Person is a Co-Trustee.
Class B Common Stock is freely convertible on a one-for-one basis into an equal number of shares of Class A Common Stock.
All options are currently exercisable.
/s/ Julia A. Gardner, Attorney-in-Fact for Herbert M. Gardner
2016-05-23