SEC Form 4 · accession 0001179110-16-028729

SUPREME INDUSTRIES INC · STS

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

Reporting owner

Officer — Exec V P and Secretary · Director · 10% Owner

Period of report

Aug 15, 2016

Accepted (ET)

Aug 16, 2016 · 7:17 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^F1	Aug 15, 2016	S	10,000	$15.89	D	633,472	D
Class A Common Stock^F2	holding	—	—		—	162,960	I	By Grantor Trust
Class A Common Stock^F3	holding	—	—		—	115,439	I	By Spouse
Class B Common Stock^F4	holding	—	—		—	885,999	D
Class B Common Stock^F4,F3	holding	—	—		—	16,857	I	By Spouse

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Incentive Stock Option^F5	$2.33	holding	—	—	—	—	Sep 30, 2017	Class A Common Stock	12,000	12,000	D

F1The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $15.88 to $15.90, 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 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.
F3Reporting person disclaims beneficial ownership of shares owned by spouse.
F4Class B Common Stock is freely convertible on a one-for-one basis into an equal number of shares of Class A Common Stock.
F5All options are currently exercisable.