0001179110-17-000342.txt : 20170104 0001179110-17-000342.hdr.sgml : 20170104 20170104180740 ACCESSION NUMBER: 0001179110-17-000342 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170103 FILED AS OF DATE: 20170104 DATE AS OF CHANGE: 20170104 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: NEILSON MARK C CENTRAL INDEX KEY: 0001251089 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08183 FILM NUMBER: 17507569 MAIL ADDRESS: STREET 1: 1361 BRIDGEWATER WAY CITY: MISHAWAKA STATE: IN ZIP: 46545 4 1 edgar.xml FORM 4 - X0306 4 2017-01-03 0 0000350846 SUPREME INDUSTRIES INC STS 0001251089 NEILSON MARK C 7140 CALABRIA COURT SAN DIEGO CA 92122 1 0 0 0 Class A CommonStock 2017-01-03 4 A 0 438 A 45728 D Not applicable - stock award. /s/ Julia A. Gardner, Attorney-in-Fact for Mark C. Neilson 2017-01-04