SEC Form 4 · accession 0001179110-16-024606

SUPREME INDUSTRIES INC · STS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Chairman of Board · Director

Period of report

May 11, 2016

Accepted (ET)

May 13, 2016 · 5:05 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	$1.48	A	434,480	D
Class A Common Stock	May 11, 2016	F	1,804	$12.89	D	432,676	D
Class A Common Stock^F1	May 11, 2016	S	1,900	$12.7147	D	430,776	D
Class A Common Stock	May 12, 2016	S	100	$12.78	D	430,676	D
Class A Common Stock^F2	holding	—	—		—	10,969	I	By GST U/W/O Mary K. Gardner
Class B Common Stock^F3	holding	—	—		—	587,862	D
Class B Common Stock^F3,F2	holding	—	—		—	66,516	I	By GST U/W/O Mary K. Gardner

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Incentive Stock Option^F5,F4	$1.48	May 11, 2016	M	15,750	D	—	Jun 25, 2016	Class A Common Stock	15,750	0	D
Incentive Stock Option^F4	$2.12	holding	—	—	—	—	Sep 30, 2017	Class A Common Stock	31,500	31,500	D

F1The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $12.68 to $12.75, inclusive. The reporting person undertakes to provide Supreme Industries, Inc., any security holder of Supreme, or the staff of the SEC, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in this footnote.
F2Reporting 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.
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 are currently exercisable.
F5Not applicable.