SEC Form 4/A · accession 0001179110-16-029913
SUPREME INDUSTRIES INC · STS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
William J Barrett
Officer — Exec V P and Secretary · Director · 10% Owner
Period of report
Jul 28, 2016
Accepted (ET)
Sep 21, 2016 · 8:41 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 StockF2 | Jul 28, 2016 | S | 32 | $16.84 | D | 158,500 | I | By Grantor Trust |
| Class A Common StockF1 | holding | — | — | — | 601,340 | D | ||
| Class A Common StockF3 | holding | — | — | — | 115,439 | 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 OptionF5 | $2.33 | holding | — | — | — | — | Sep 30, 2017 | Class A Common Stock | 12,000 | 12,000 | D |
Explanation of responses
- F1Amendment required due to brokerage statement issues to reverse reflection of sale of 40,000 Class A shares.
- 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.