0000076605-24-000036.txt : 20240130 0000076605-24-000036.hdr.sgml : 20240130 20240130214648 ACCESSION NUMBER: 0000076605-24-000036 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240126 FILED AS OF DATE: 20240130 DATE AS OF CHANGE: 20240130 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ellis Kip B CENTRAL INDEX KEY: 0001685896 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03922 FILM NUMBER: 24580456 MAIL ADDRESS: STREET 1: 107 W. FRANKLIN STREET, P.O. BOX 638 CITY: ELKHART STATE: IN ZIP: 46515 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PATRICK INDUSTRIES INC CENTRAL INDEX KEY: 0000076605 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLE PARTS & ACCESSORIES [3714] ORGANIZATION NAME: 04 Manufacturing 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 wk-form4_1706669197.xml FORM 4 X0508 4 2024-01-26 0 0000076605 PATRICK INDUSTRIES INC PATK 0001685896 Ellis Kip B 107 W. FRANKLIN ST ELKHART IN 46515 0 1 0 0 President-Powersports/ Housing 0 Common Stock 2024-01-26 4 J 0 5714 0 A 128775 D Common Stock 2024-01-26 4 F 0 8556 94.77 D 120219 D Represents an adjustment to the number of shares that the reporting owner is entitled to upon vesting in January 2024 of a performance-based grant originally awarded in January 2021. 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 2021 that vested after three years upon the achievement of target Company objectives. /s/ Kip B. Ellis by Joel D. Duthie, attorney-in-fact 2024-01-30