0001179110-16-025883.txt : 20160602 0001179110-16-025883.hdr.sgml : 20160602 20160602175357 ACCESSION NUMBER: 0001179110-16-025883 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160531 FILED AS OF DATE: 20160602 DATE AS OF CHANGE: 20160602 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: 161693678 MAIL ADDRESS: STREET 1: P O BOX 6199 CITY: FAIR HAVEN STATE: NJ ZIP: 07704 4 1 edgar.xml FORM 4 - X0306 4 2016-05-31 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 2016-05-31 4 S 0 300 13.33 D 414376 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 2016-06-02