0000076605-22-000019.txt : 20220127 0000076605-22-000019.hdr.sgml : 20220127 20220127211732 ACCESSION NUMBER: 0000076605-22-000019 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220125 FILED AS OF DATE: 20220127 DATE AS OF CHANGE: 20220127 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NEMETH ANDY L CENTRAL INDEX KEY: 0001209929 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03922 FILM NUMBER: 22565075 MAIL ADDRESS: STREET 1: C/O PATRICK INDUSTRIES, INC., STREET 2: P.O. BOX 638 CITY: ELKHART STATE: IN ZIP: 46515-0638 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PATRICK INDUSTRIES INC CENTRAL INDEX KEY: 0000076605 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLE PARTS & ACCESSORIES [3714] IRS NUMBER: 351057796 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 107 WEST FRANKLIN STREET PO BOX 638 CITY: ELKHART STATE: IN ZIP: 46515 BUSINESS PHONE: 574-294-7511 MAIL ADDRESS: STREET 1: 107 WEST FRANKLIN STREET PO BOX 638 CITY: ELKHART STATE: IN ZIP: 46515 4 1 wf-form4_164333623683410.xml FORM 4 X0306 4 2022-01-25 0 0000076605 PATRICK INDUSTRIES INC PATK 0001209929 NEMETH ANDY L 107 W. FRANKLIN ST ELKHART IN 46515 1 1 0 0 Chief Executive Officer Common Stock 2022-01-25 4 F 0 3784 64.96 D 258282 D Common Stock 2022-01-25 4 F 0 30279 64.96 D 228003 D Common Stock 2022-01-26 4 A 0 46755 0 A 274758 D Common Stock 2022-01-26 4 A 0 7792 0 A 282550 D Represents shares of common stock returned to the Company to satisfy the tax withholding obligation associated with a time-based stock grant awarded in January 2019 that became fully vested in January 2022. Represents shares of common stock returned to the Company to satisfy the tax withholding obligation associated with a performance-based stock grant awarded in January 2019 that vested after three years upon the achievement of target Company objectives. Shares are performance-based and vest after three years upon achievement of target Company objectives. Annual Management time-based grant awarded January 2022 and vesting in January 2025. /s/ Andy L. Nemeth by Jacob R. Petkovich, attorney-in-fact 2022-01-27