SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES


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*
Gonzalez Hugo E

(Last) (First) (Middle)
107 W. FRANKLIN STREET
PO BOX 638

(Street)
ELKHART IN 46515

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/24/2024
3. Issuer Name and Ticker or Trading Symbol
PATRICK INDUSTRIES INC [ PATK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP Operations & COO
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 23,759(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Common Stock Options 05/14/2023 05/14/2029 Common Stock 4,875 41.33 D
Explanation of Responses:
1. Represents the aggregate of shares beneficially owned and comprised of: (1) 3,695 time-based shares granted in January 2022, 2023 and 2024 to the Reporting Person by the Issuer and vesting in January 2025, 2026 and 2027, respectively; (2) 14,779 performance-based shares granted in January 2022, 2023 and 2024 which will vest after three years upon achievement of target Company objectives in January 2025, 2026 and 2027 , respectively; and (3) 5,285 shares owned directly by the Reporting Person. The vesting of both the time-based and performance-based share awards is subject to the terms of each of the awards, including the Reporting Person's continued employment with the Issuer.
Remarks:
/s/Hugo E. Gonzalez by Joel D. Duthie, attorney-in-fact 02/02/2024
** 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 5 (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.

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