SEC Form 4 · accession 0000076605-17-000151
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
Nov 30, 2017
Accepted (ET)
Dec 4, 2017 · 9:26 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 Stock | Nov 30, 2017 | M | 12,500 | $18.45 | A | 353,327 | D | |
| Common Stock | Nov 30, 2017 | M | 12,500 | $22.13 | A | 365,827 | D | |
| Common Stock | Nov 30, 2017 | M | 12,500 | $26.56 | A | 378,327 | D | |
| Common Stock | Nov 30, 2017 | M | 12,500 | $31.87 | A | 390,827 | D | |
| Common Stock | Nov 30, 2017 | D | 12,230 | $101.20 | D | 378,597 | D | |
| Common Stock | Nov 30, 2017 | F | 17,127 | $101.20 | D | 361,470 | 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 Appreciation RightsF2,F3 | $18.45 | Nov 30, 2017 | M | 12,500 | D | — | Dec 18, 2022 | Common Stock | 12,500 | 12,499 | D |
| Stock Appreciation RightsF2,F3 | $22.13 | Nov 30, 2017 | M | 12,500 | D | — | Dec 18, 2022 | Common Stock | 12,500 | 12,499 | D |
| Stock Appreciation RightsF2,F3 | $26.56 | Nov 30, 2017 | M | 12,500 | D | — | Dec 18, 2022 | Common Stock | 12,500 | 12,499 | D |
| Stock Appreciation RightsF2,F3 | $31.87 | Nov 30, 2017 | M | 12,500 | D | — | Dec 18, 2022 | Common Stock | 12,500 | 12,499 | D |
Explanation of responses
- F1Reflects exercise of the stock appreciation rights reported on Table II of this Form 4.
- F2Reflects stock appreciation rights that were granted on December 18, 2013.
- F3The stock appreciation rights exercised on November 30, 2017 became exercisable on December 18, 2016.