UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

 

FORM 15

 

 

 

CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION

UNDER SECTION 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934

OR SUSPENSION OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND 15(d)

OF THE SECURITIES EXCHANGE ACT OF 1934.

 

Commission File Number 001-08183

 

 

 

SUPREME INDUSTRIES, INC.

(Exact name of registrant as specified in its charter)

 

 

 

P.O. Box 237

2581 E. Kercher Road

Goshen, Indiana

(574) 642-3070

 

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)

 

CLASS A COMMON STOCK, PAR VALUE $0.10 PER SHARE 

(Title of each class of securities covered by this Form)

 

None

(Titles of all other classes of securities for which a duty to file reports under section 13(a) or 15(d) remains)

 

 

 

Please place an X in the box(es) to designate the appropriate rule provision(s) relied upon to terminate or suspend the duty to file reports:

 

     
Rule 12g-4(a)(1)   x
Rule 12g-4(a)(2)   ¨
Rule 12h-3(b)(1)(i)   x
Rule 12h-3(b)(1)(ii)   ¨
Rule 15d-6   ¨

 

 

Approximate number of holders of record as of the certification or notice date: 1

 

 

 

 

 

 

Pursuant to the requirements of the Securities Exchange Act of 1934, Supreme Industries, Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.

 

       
  Supreme Industries, Inc.  
       
Date: October 10, 2017 By:

/s/ Jeffery L. Taylor

 
  Name: Jeffery L. Taylor  
  Title: Vice President  

 

 

 

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