SEC Form 4 · accession 0000076605-17-000009
PATRICK INDUSTRIES INC · PATK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Todd M Cleveland
Officer — CEO · Director
Period of report
Jan 17, 2017
Accepted (ET)
Jan 19, 2017 · 9:05 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000076605
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jan 17, 2017 | A | 4,286 | $0.00 | A | 340,384 | D | |
| Common StockF2 | Jan 17, 2017 | A | 25,715 | $0.00 | A | 366,099 | D | |
| Common Stock | holding | — | — | — | 15,000 | I | Held by family members living in household |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Options | $80.75 | Jan 17, 2017 | A | 34,808 | A | Jan 17, 2018 | Jan 17, 2026 | Common Stock | 34,808 | 34,808 | D |
| Stock Options | $80.75 | Jan 17, 2017 | A | 34,807 | A | Jan 17, 2019 | Jan 17, 2026 | Common Stock | 34,807 | 69,615 | D |
| Stock Options | $80.75 | Jan 17, 2017 | A | 34,808 | A | Jan 17, 2020 | Jan 17, 2026 | Common Stock | 34,808 | 104,423 | D |
| Stock Options | $80.75 | Jan 17, 2017 | A | 34,807 | A | Jan 17, 2021 | Jan 17, 2026 | Common Stock | 34,807 | 139,230 | D |
| Stock Appreciation Rights | $80.75 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2018 | Jan 17, 2026 | Common Stock | 8,702 | 8,702 | D |
| Stock Appreciation Rights | $80.75 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2019 | Jan 17, 2026 | Common Stock | 8,702 | 17,404 | D |
| Stock Appreciation Rights | $80.75 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2020 | Jan 17, 2026 | Common Stock | 8,702 | 26,106 | D |
| Stock Appreciation Rights | $80.75 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2021 | Jan 17, 2026 | Common Stock | 8,702 | 34,808 | D |
| Stock Appreciation Rights | $90.04 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2018 | Jan 17, 2026 | Common Stock | 8,702 | 8,702 | D |
| Stock Appreciation Rights | $90.04 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2019 | Jan 17, 2026 | Common Stock | 8,702 | 17,404 | D |
| Stock Appreciation Rights | $90.04 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2020 | Jan 17, 2026 | Common Stock | 8,702 | 26,106 | D |
| Stock Appreciation Rights | $90.04 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2021 | Jan 17, 2026 | Common Stock | 8,702 | 34,808 | D |
| Stock Appreciation Rights | $100.39 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2018 | Jan 17, 2026 | Common Stock | 8,702 | 8,702 | D |
| Stock Appreciation Rights | $100.39 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2019 | Jan 17, 2026 | Common Stock | 8,702 | 17,404 | D |
| Stock Appreciation Rights | $100.39 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2020 | Jan 17, 2026 | Common Stock | 8,702 | 26,106 | D |
| Stock Appreciation Rights | $100.39 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2021 | Jan 17, 2026 | Common Stock | 8,702 | 34,808 | D |
| Stock Appreciation Rights | $111.94 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2018 | Jan 17, 2026 | Common Stock | 8,702 | 8,702 | D |
| Stock Appreciation Rights | $111.94 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2019 | Jan 17, 2026 | Common Stock | 8,702 | 17,404 | D |
| Stock Appreciation Rights | $111.94 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2020 | Jan 17, 2026 | Common Stock | 8,702 | 26,106 | D |
| Stock Appreciation Rights | $111.94 | Jan 17, 2017 | A | 8,702 | A | Jan 17, 2021 | Jan 17, 2026 | Common Stock | 8,702 | 34,808 | D |
Explanation of responses
- F1Annual Management Grant awarded 01/17/2017 and vesting on 01/17/2020.
- F2Shares are performance-based and vest after three years upon achievement of target Company objectives.