0001179110-16-028027.txt : 20160729 0001179110-16-028027.hdr.sgml : 20160729 20160729173718 ACCESSION NUMBER: 0001179110-16-028027 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160727 FILED AS OF DATE: 20160729 DATE AS OF CHANGE: 20160729 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: BARRETT WILLIAM J CENTRAL INDEX KEY: 0000923415 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 161795194 MAIL ADDRESS: STREET 1: P O BOX 6199 CITY: FAIR HAVEN STATE: NJ ZIP: 07704 4 1 edgar.xml FORM 4 - X0306 4 2016-07-27 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 651604 D Class A Common Stock 2016-07-27 4 S 0 1909 16.84 D 164591 I By Grantor Trust Class A Common Stock 115439 I By Spouse Class B Common Stock 885999 D Class B Common Stock 16857 I By Spouse Incentive Stock Option 2.33 2017-09-30 Class A Common Stock 24000 24000 D Reporting person disclaims beneficial ownership of shares owned by grantor trust except to the extent of the pecuniary interest owned by the reporting person and his spouse. Reporting person is the trustee of the grantor trust. Reporting person disclaims beneficial ownership of shares owned by spouse. 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 William J. Barrett 2016-07-29