SEC Form 4 · accession 0001179110-15-007195
SUPREME INDUSTRIES INC · STS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
William J Barrett
Officer — Exec V P and Secretary · Director · 10% Owner
Period of report
May 4, 2015
Accepted (ET)
May 6, 2015 · 4:45 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000350846
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common Stock | May 4, 2015 | M | 35,323 | $5.09 | A | 661,823 | D | |
| Class A Common StockF1 | holding | — | — | — | 178,500 | I | By Grantor Trust | |
| Class A Common StockF2 | holding | — | — | — | 115,439 | I | By Spouse | |
| Class B Common Stock | holding | — | — | — | 885,999 | D | ||
| Class B Common StockF2 | holding | — | — | — | 16,857 | I | By Spouse |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Incentive Stock Option (Reload)F3 | $5.09 | May 4, 2015 | M | 35,323 | D | — | May 7, 2015 | Class A Common | 35,323 | 0 | D |
| Incentive Stock OptionF3 | $1.63 | holding | — | — | — | — | Jun 25, 2016 | Class A Common Stock | 15,750 | 15,750 | D |
| Incentive Stock OptionF3 | $2.33 | holding | — | — | — | — | Sep 30, 2017 | Class A Common Stock | 31,500 | 31,500 | D |
Explanation of responses
- F1Reporting 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.
- F2Reporting Person disclaims beneficial ownership of shares owned by spouse.
- F3All options currently exercisable.