0000076605-21-000033.txt : 20210128 0000076605-21-000033.hdr.sgml : 20210128 20210128214609 ACCESSION NUMBER: 0000076605-21-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210126 FILED AS OF DATE: 20210128 DATE AS OF CHANGE: 20210128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rodino Jeff CENTRAL INDEX KEY: 0001491923 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03922 FILM NUMBER: 21567763 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: MOTOR VEHICLE PARTS & ACCESSORIES [3714] 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 wf-form4_161188835388372.xml FORM 4 X0306 4 2021-01-26 0 0000076605 PATRICK INDUSTRIES INC PATK 0001491923 Rodino Jeff 107 W. FRANKLIN ST ELKHART IN 46515 0 1 0 0 EVP Sales & CSO Common Stock 2021-01-26 4 F 0 709 69.97 D 117467 D Common Stock 2021-01-26 4 F 0 2166 69.61 D 115301 D Common Stock 2021-01-26 4 J 0 3167 0 D 112134 D Represents shares of common stock returned to the Company to satisfy the tax withholding obligation associated with a time-based stock grant awarded in January 2018 that became fully vested 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 2018 that vested after three years upon the achievement of target Company objectives. Represents an adjustment to the number of shares that the reporting owner is entitled to upon vesting in January 2021 of a performance-based grant originally awarded in January 2018. /s/ Jeffrey M. Rodino by Jacob R. Petkovich, attorney-in-fact 2021-01-28