SEC Form 4 · accession 0001179110-16-029799
SUPREME INDUSTRIES INC · STS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
William J Barrett
Officer — Exec V P and Secretary · Director · 10% Owner
Period of report
Sep 15, 2016
Accepted (ET)
Sep 19, 2016 · 4:27 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 | Sep 15, 2016 | M | 12,000 | $2.33 | A | 483,340 | D | |
| Class A Common Stock | Sep 15, 2016 | F | 1,486 | $18.84 | D | 481,854 | D | |
| Class A Common StockF1 | Sep 15, 2016 | S | 25,000 | $18.436 | D | 456,854 | D | |
| Class A Common StockF2 | holding | — | — | — | 158,500 | I | By Grantor Trust | |
| Class A Common StockF3 | holding | — | — | — | 85,439 | I | By Spouse | |
| Class B Common StockF4 | holding | — | — | — | 885,999 | D | ||
| Class B Common StockF4,F3 | 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 OptionF6,F5 | $2.33 | Sep 15, 2016 | M | 12,000 | D | — | Sep 30, 2017 | Class A Common Stock | 12,000 | 0 | 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 $18.41 to $18.46, 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.
- F6Not applicable.