0001179110-16-030437.txt : 20161005 0001179110-16-030437.hdr.sgml : 20161005 20161005123815 ACCESSION NUMBER: 0001179110-16-030437 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161003 FILED AS OF DATE: 20161005 DATE AS OF CHANGE: 20161005 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 Peter D CENTRAL INDEX KEY: 0001608380 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 161921829 MAIL ADDRESS: STREET 1: 1229 RIDGEDALE CITY: SOUTH BEND STATE: IN ZIP: 46614 4 1 edgar.xml FORM 4 - X0306 4 2016-10-03 0 0000350846 SUPREME INDUSTRIES INC STS 0001608380 Barrett Peter D 2581 EAST KERCHER ROAD GOSHEN IN 46528 1 0 0 0 Class A Common Stock 2016-10-03 4 A 0 356 A 5081 D Class B Common Stock 29467 D Not applicable - stock award. Class B Common Stock is freely convertible on a one-for-one basis into an equal number of shares of Class A Common Stock. s/ Julia A. Gardner, Attorney-in-Fact for Peter D. Barrett 2016-10-05