0001179110-16-029372.txt : 20160907
0001179110-16-029372.hdr.sgml : 20160907
20160907121437
ACCESSION NUMBER: 0001179110-16-029372
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160906
FILED AS OF DATE: 20160907
DATE AS OF CHANGE: 20160907
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: 161872835
MAIL ADDRESS:
STREET 1: P O BOX 6199
CITY: FAIR HAVEN
STATE: NJ
ZIP: 07704
4
1
edgar.xml
FORM 4 -
X0306
4
2016-09-06
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
2016-09-06
4
S
0
2362
17.63
D
493978
D
Class A Common Stock
158500
I
By Grantor Trust
Class A Common Stock
2016-09-06
4
S
0
2972
17.63
D
107467
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
12000
12000
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
2016-09-07