SEC Form 4 · accession 0001179110-16-024518
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 11, 2016
Accepted (ET)
May 12, 2016 · 9:26 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 11, 2016 | M | 15,750 | $1.63 | A | 677,573 | D | |
| Class A Common Stock | May 11, 2016 | F | 1,990 | $12.89 | D | 675,583 | D | |
| Class A Common Stock | May 11, 2016 | M | 7,500 | $2.33 | A | 683,083 | D | |
| Class A Common Stock | May 11, 2016 | F | 1,358 | $12.89 | D | 681,725 | D | |
| Class A Common Stock | May 11, 2016 | S | 2,000 | $12.60 | D | 679,725 | 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 StockF3 | holding | — | — | — | 885,999 | D | ||
| Class B Common StockF3,F2 | 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 OptionF5,F4 | $1.63 | May 11, 2016 | M | 15,750 | D | — | Jun 25, 2016 | Class A Common Stock | 15,750 | 0 | D |
| Incentive Stock OptionF5,F4 | $2.33 | May 11, 2016 | M | 7,500 | D | — | Sep 30, 2017 | Class A Common Stock | 7,500 | 24,000 | 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.
- F3Class B Common Stock is freely convertible on a one-for-one basis into an equal number of shares of Class A Common Stock.
- F4All options currently exercisable.
- F5Not applicable.