FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIESFiled 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/08/2024 |
3. Issuer Name and Ticker or Trading Symbol
PATRICK INDUSTRIES INC [ PATK ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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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) |
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Common Stock | 14,326(1) | D |
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) | ||
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Common Stock Options | 05/14/2023(2) | 05/14/2029 | Common Stock | 3,900 | 41.33 | D |
Explanation of Responses: |
1. Represents the aggregate of 12,368 shares benefically owned and granted to the Reporting Person by the Issuer and comprised of (a) 2,473 time-based restricted stock awards granted between January 2022 and January 2024 which will vest three years from the respective grant dates and (b) 9,895 performance-based restricted stock awards granted between January 2022 and January 2024 which will vest upon achievement of target Company objectives. The vesting of both the time 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. In addition, there are 1,958 shares held by the Reporting Person that vested in prior years. |
2. Reflects the date the stock options became fully exercisable. |
Remarks: |
/s/ Charles R. Roeder by Joel D. Duthie, attorney-in-fact | 03/14/2024 | |
** 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.
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.