0001179110-16-029285.txt : 20160902 0001179110-16-029285.hdr.sgml : 20160902 20160902173511 ACCESSION NUMBER: 0001179110-16-029285 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160901 FILED AS OF DATE: 20160902 DATE AS OF CHANGE: 20160902 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: 161869477 MAIL ADDRESS: STREET 1: P O BOX 6199 CITY: FAIR HAVEN STATE: NJ ZIP: 07704 4 1 edgar.xml FORM 4 - X0306 4 2016-09-01 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 2016-09-01 4 S 0 25040 17.34 D 284089 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 The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $17.27 to $17.42, inclusive. The reporting person undertakes to provide Supreme Industries, Inc., any security holder of Supreme, or the staff of the SEC, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in this footnote 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 2016-09-02