0000076605-25-000055.txt : 20250213 0000076605-25-000055.hdr.sgml : 20250213 20250213205613 ACCESSION NUMBER: 0000076605-25-000055 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20241231 FILED AS OF DATE: 20250213 DATE AS OF CHANGE: 20250213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Forbes John A CENTRAL INDEX KEY: 0001528477 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03922 FILM NUMBER: 25622613 MAIL ADDRESS: STREET 1: 107 W. FRANKLIN STREET, 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] ORGANIZATION NAME: 04 Manufacturing IRS NUMBER: 351057796 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 107 WEST FRANKLIN STREET CITY: ELKHART STATE: IN ZIP: 46516 BUSINESS PHONE: 574-294-7511 MAIL ADDRESS: STREET 1: 107 WEST FRANKLIN STREET PO BOX 638 CITY: ELKHART STATE: IN ZIP: 46515 5 1 wk-form5_1739498167.xml FORM 5 X0508 5 2024-12-31 0 0 0 0000076605 PATRICK INDUSTRIES INC PATK 0001528477 Forbes John A 107 W. FRANKLIN ST ELKHART IN 46516 1 0 0 0 0 Common Stock 53891 D The Common Stock holding reported herein has been adjusted to reflect a three-for-two stock split paid by the issuer on December 13, 2024. /s/ John A. Forbes by Joel D. Duthie, attorney-in-fact 2025-02-13