SEC Form 4 · accession 0001179110-16-025730
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 27, 2016
Accepted (ET)
May 31, 2016 · 5:08 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 StockF1 | May 27, 2016 | S | 8,293 | $13.0742 | D | 414,676 | D | |
| Class A Common StockF2 | holding | — | — | — | 10,969 | I | By GST U/W/O Mary K. Gardner | |
| Class B Common StockF3 | holding | — | — | — | 587,862 | D | ||
| Class B Common StockF3,F2 | holding | — | — | — | 66,516 | I | By GST U/W/O Mary K. Gardner |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Incentive Stock OptionF4 | $2.12 | holding | — | — | — | — | Sep 30, 2017 | Class A Common Stock | 31,500 | 31,500 | D |
Explanation of responses
- F1The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $13.0100 to $13.1900, 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.