0001209191-18-014910.txt : 20180301 0001209191-18-014910.hdr.sgml : 20180301 20180301154722 ACCESSION NUMBER: 0001209191-18-014910 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180301 FILED AS OF DATE: 20180301 DATE AS OF CHANGE: 20180301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GOEDKEN DENNIS W CENTRAL INDEX KEY: 0001732428 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20572 FILM NUMBER: 18657016 MAIL ADDRESS: STREET 1: 1031 MENDOTA HEIGHTS ROAD CITY: ST. PAUL STATE: MN ZIP: 55120 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PATTERSON COMPANIES, INC. CENTRAL INDEX KEY: 0000891024 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 410886515 STATE OF INCORPORATION: MN FISCAL YEAR END: 0426 BUSINESS ADDRESS: STREET 1: 1031 MENDOTA HEIGHTS RD CITY: ST PAUL STATE: MN ZIP: 55120-1401 BUSINESS PHONE: 6516861600 MAIL ADDRESS: STREET 1: 1031 MENDOTA HEIGHTS RD CITY: ST PAUL STATE: MN ZIP: 55120-1401 FORMER COMPANY: FORMER CONFORMED NAME: PATTERSON DENTAL CO DATE OF NAME CHANGE: 19950111 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-03-01 0 0000891024 PATTERSON COMPANIES, INC. PDCO 0001732428 GOEDKEN DENNIS W 1031 MENDOTA HEIGHTS ROAD ST. PAUL MN 55120 0 1 0 0 Interim CFO Common Stock 4285 D Common Stock 815 I By ESOP Includes 1,576 shares of restricted stock received through awards in the years 2013 through 2015 to Reporting Person, which vest, contingent upon continued employment, as follows: 297 shares vest 4/29/2018, 282 shares vest 7/1/2018, 238 shares vest 7/1/2018, 283 shares vest 7/1/2019, 238 shares vest 7/1/2019 and 238 shares vest 7/1/2020. Includes 2,289 Restricted Stock Units ("RSUs") awarded on 7/1/2016 and 7/1/2017 to Reporting Person pursuant the Patterson Companies, Inc. 2015 Omnibus Incentive Plan. Each RSU represents a right, contingent upon continued employment, to receive one share of common stock. The 2016 RSUs vest as follows: 248 shares vest each year on the anniversary of the grant from 2018 through 2021. The 2017 RSUs vest as follows: 259 shares vest each year on the anniversary of the grant from 2018 through 2020 and 260 shares vest 7/1/2021 and 7/1/2022. Represents shares of common stock indirectly held by the Reporting Person's Employee Stock Ownership Plan (ESOP) accounting through January 2, 2018. Les B. Korsh, by Power of Attorney 2018-03-01 EX-24.3_773833 2 poa.txt POA DOCUMENT LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS Know all by these presents, that the undersigned's hereby makes, constitutes and appoints Les B. Korsh as the undersigned's true and lawful attorney-in-fact, with full power and authority as hereinafter described on behalf of and in the name, place and stead of the undersigned to: (1) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director and/or 10% beneficial owner of Patterson Companies, Inc. (the "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended, and the rules thereunder; (2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5 and timely file such form with the United States Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned acknowledges that the foregoing attorney-in-fact, in serving in such capacity at the request of the undersigned, is not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934, as amended. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorney-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 21st day of February, 2018. /s/ Dennis W. Goedken Signature STATE OF MINNESOTA COUNTY OF DAKOTA On this 21st day of February, 2018, Dennis W. Goedken personally appeared before me, and acknowledged that s/he executed the foregoing instrument for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. /s/ Kim U. Poirier Notary Public My Commission Expires January 31, 2020