SEC Form 4 · accession 0001437749-16-039226
PATRICK INDUSTRIES INC · PATK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Andy L Nemeth
Officer — President · Director
Period of report
Sep 26, 2016
Accepted (ET)
Sep 28, 2016 · 9:28 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000076605
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Options | $61.43 | Sep 26, 2016 | A | 12,240 | A | Sep 26, 2017 | Sep 26, 2025 | Common Stock | 12,240 | 12,240 | D |
| Stock Options | $61.43 | Sep 26, 2016 | A | 12,240 | A | Sep 26, 2018 | Sep 26, 2025 | Common Stock | 12,240 | 24,480 | D |
| Stock Options | $61.43 | Sep 26, 2016 | A | 12,240 | A | Sep 26, 2019 | Sep 26, 2025 | Common Stock | 12,240 | 36,720 | D |
| Stock Options | $61.43 | Sep 26, 2016 | A | 12,240 | A | Sep 26, 2020 | Sep 26, 2025 | Common Stock | 12,240 | 48,960 | D |
| Stock Appreciation Rights | $61.43 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2017 | Sep 26, 2025 | Common Stock | 3,060 | 3,060 | D |
| Stock Appreciation Rights | $61.43 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2018 | Sep 26, 2025 | Common Stock | 3,060 | 6,120 | D |
| Stock Appreciation Rights | $61.43 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2019 | Sep 26, 2025 | Common Stock | 3,060 | 9,180 | D |
| Stock Appreciation Rights | $61.43 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2020 | Sep 26, 2025 | Common Stock | 3,060 | 12,240 | D |
| Stock Appreciation Rights | $71.26 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2017 | Sep 26, 2025 | Common Stock | 3,060 | 3,060 | D |
| Stock Appreciation Rights | $71.26 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2018 | Sep 26, 2025 | Common Stock | 3,060 | 6,120 | D |
| Stock Appreciation Rights | $71.26 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2019 | Sep 26, 2025 | Common Stock | 3,060 | 9,180 | D |
| Stock Appreciation Rights | $71.26 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2020 | Sep 26, 2025 | Common Stock | 3,060 | 12,240 | D |
| Stock Appreciation Rights | $82.66 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2017 | Sep 26, 2025 | Common Stock | 3,060 | 3,060 | D |
| Stock Appreciation Rights | $82.66 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2018 | Sep 26, 2025 | Common Stock | 3,060 | 6,120 | D |
| Stock Appreciation Rights | $82.66 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2019 | Sep 26, 2025 | Common Stock | 3,060 | 9,180 | D |
| Stock Appreciation Rights | $82.66 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2020 | Sep 26, 2025 | Common Stock | 3,060 | 12,240 | D |
| Stock Appreciation Rights | $95.89 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2017 | Sep 26, 2025 | Common Stock | 3,060 | 3,060 | D |
| Stock Appreciation Rights | $95.89 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2018 | Sep 26, 2025 | Common Stock | 3,060 | 6,120 | D |
| Stock Appreciation Rights | $95.89 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2019 | Sep 26, 2025 | Common Stock | 3,060 | 9,180 | D |
| Stock Appreciation Rights | $95.89 | Sep 26, 2016 | A | 3,060 | A | Sep 26, 2020 | Sep 26, 2025 | Common Stock | 3,060 | 12,240 | D |