Statement of Changes in Beneficial Ownership (4)
28 Septiembre 2017 - 9:17AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
WABASH NATIONAL CORP /DE
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2. Issuer Name
and
Ticker or Trading Symbol
SUPREME INDUSTRIES INC
[
STS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
1000 SAGAMORE PARKWAY SOUTH
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3. Date of Earliest Transaction
(MM/DD/YYYY)
9/27/2017
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(Street)
LAFAYETTE, IN 47905
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class A Common Stock, par value $0.10
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9/27/2017
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P
(1)
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1564881
(1)
(2)
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A
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$21.00
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0
(3)
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(1)
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These shares were acquired pursuant to an Agreement and Plan of Merger, dated August 8, 2017 (the "Merger Agreement"), by and among the Reporting Person, Redhawk Acquisition Corporation, a wholly owned subsidiary of the Reporting Person ("Purchaser"), and the Issuer. Pursuant to the Merger Agreement, the Reporting Person acquired all of the outstanding shares of the Issuer's Class A common stock, par value $0.10, and Class B common stock, par value $0.10, in a two-step transaction involving, first, the completion of a tender offer by the Reporting Person and Purchaser (the "Tender Offer"), and, second, a back-end merger for 100% ownership pursuant to which Purchaser merged with and into the Issuer and the Reporting Person acquired all of the outstanding shares of the Issuer that were not acquired by Purchaser in the Tender Offer.
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(2)
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Upon the completion of the tender offer described above in footnote 1, all of the Issuer's outstanding Class B common stock, par value $0.10, converted into shares of Class A Common Stock on a one-for-one basis.
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(3)
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Upon the merger of the Purchaser with and into the Issuer, all of the outstanding shares of Issuer's Class A common stock were canceled and the Issuer became a wholly owned subsidiary of the Reporting Person.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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WABASH NATIONAL CORP /DE
1000 SAGAMORE PARKWAY SOUTH
LAFAYETTE, IN 47905
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X
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Signatures
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Richard J. Giromini, Chief Executive Officer of Wabash National Corporation
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9/28/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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