Supreme Industries (STS) Form 4 SUPREME INDUSTRIES / Peter D Barrett ownership change

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

Barrett Peter D

(Last) (First) (Middle)

2581 EAST KERCHER ROAD

(Street)

GOSHEN IN 46528

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
SUPREME INDUSTRIES INC [ STS ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
09/06/2017

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
			Code	V	Amount	(A) or (D)	Price
Class A Common Stock	09/06/2017		J(1)		26,700	A	$0	26,700	I	By Trust(2)(3)(4)
Class A Common Stock	09/06/2017		J		26,700(5)	D	$0	0	I	By Trust(2)(3)(4)
Class A Common Stock								33,321(6)	D(3)(4)
Class B Common Stock								29,467(7)	D(3)(4)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
				Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares

Explanation of Responses:

1. Represents shares of Class A common stock of Supreme Industries, Inc., par value $0.10 per share ("Class A Shares"), that were ultimately received in connection with a distribution by an independently controlled limited liability company to its members.

2. Represents Class A Shares held directly by the Peter D. Barrett 2012 Irrevocable Trust (the "Trust"). Peter D. Barrett is the trustee and beneficiary of, and may be deemed to beneficially own securities held by, the Trust.

3. This statement is filed by and on behalf of Peter D. Barrett. Mr. Barrett and the Trust are the direct beneficial owners of the securities covered by this statement.

4. The reporting person states that neither the filing of this statement nor anything herein shall be deemed an admission that such person is, for purposes of Section 16 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), or otherwise, the beneficial owner of any securities covered by this statement. The reporting person disclaims beneficial ownership of the securities covered by this statement, except to the extent of the pecuniary interest of such person in such securities.

5. Represents Class A Shares that were distributed by the Trust to Mr. Barrett, as the sole beneficiary of the Trust (the "Trust Distribution").

6. Includes all 26,700 Class A Shares that were distributed by the Trust to Mr. Barrett in connection with the Trust Distribution. The acquisition of such Class A Shares by Mr. Barrett in connection with the Trust Distribution constituted a change in the form of beneficial ownership without a change in pecuniary interest that is exempt from Section 16 of the Exchange Act pursuant to Rule 16a-13 thereunder. Rule 16a-9(a) under the Exchange Act may also exempt the acquisition of such Class A Shares by Mr. Barrett in connection with the Trust Distribution from Section 16 of the Exchange Act.

7. Represents shares of Class B common stock of Supreme Industries, Inc., par value $0.10 per share ("Class B Shares"). Class B Shares are freely convertible on a one-to-one basis into an equal number of Class A Shares.

	s/ Julia A. Gardner, Attorney-in-Fact for Peter D. Barrett	09/14/2017
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.