0001140361-11-033771.txt : 20110622
0001140361-11-033771.hdr.sgml : 20110622
20110622113056
ACCESSION NUMBER: 0001140361-11-033771
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110622
FILED AS OF DATE: 20110622
DATE AS OF CHANGE: 20110622
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Blosser Courtney
CENTRAL INDEX KEY: 0001491924
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-03922
FILM NUMBER: 11925090
MAIL ADDRESS:
STREET 1: 107 W. FRANKLIN STREET
STREET 2: 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: MILLWOOD, VENEER, PLYWOOD & STRUCTURAL WOOD MEMBERS [2430]
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: 574-206-7515
MAIL ADDRESS:
STREET 1: 107 WEST FRANKLIN STREET PO BOX 638
CITY: ELKHART
STATE: IN
ZIP: 46515
4
1
doc1.xml
FORM 4
X0303
4
2011-06-22
0
0000076605
PATRICK INDUSTRIES INC
PATK
0001491924
Blosser Courtney
107 W. FRANKLIN ST
ELKHART
IN
46515
0
1
0
0
VP Human Resources
Common Stock
2011-06-22
4
P
0
400
2.06
A
41900
D
Courtney Blosser by Andy L. Nemeth, attorney-in-fact
2011-06-22