SEC Form 4 · accession 0001179110-15-007274
SUPREME INDUSTRIES INC · STS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Herbert M Gardner
Officer — Chairman of Board · Director
Period of report
May 5, 2015
Accepted (ET)
May 7, 2015 · 5:40 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 5, 2015 | M | 32,111 | $4.62 | A | 418,730 | D | |
| Class A Common StockF1 | holding | — | — | — | 10,969 | I | By Estate of Wife | |
| Class B Common Stock | holding | — | — | — | 587,862 | D | ||
| Class B Common StockF1 | holding | — | — | — | 66,516 | I | By Estate of Wife |
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)F2 | $4.62 | May 5, 2015 | M | 32,111 | D | — | May 7, 2015 | Class A Commmon Stock | 32,111 | 0 | D |
| Incentive Stock OptionF2 | $1.48 | holding | — | — | — | — | Jun 25, 2016 | Class A Common Stock | 15,750 | 15,750 | D |
| Incentive Stock OptionF2 | $2.12 | 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 the Generation Skipping Marital Trust U/W/O Mary K. Gardner, of which the Reporting Person is a Co-Trustee.
- F2Currently exercisable.