Patrick Industries (PATK) Form 4 PATRICK INDUSTRIES / Todd M Cleveland ownership change

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

OMB APPROVAL

OMB Number:	3235-0287
Estimated average burden
hours per response:	0.5

Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

Cleveland Todd M

(Last) (First) (Middle)

107 W. FRANKLIN ST

(Street)

ELKHART IN 46515

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
PATRICK INDUSTRIES INC [ PATK ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
X	Officer (give title below)	Other (specify below)
CEO

3. Date of Earliest Transaction (Month/Day/Year)
01/17/2017

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
			Code	V	Amount	(A) or (D)	Price
Common Stock	01/17/2017		A		4,286	A	$0(1)	340,384	D
Common Stock	01/17/2017		A		25,715	A	$0(2)	366,099	D
Common Stock								15,000	I	Held by family members living in household

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
				Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Stock Options	$80.75	01/17/2017		A		34,808		01/17/2018	01/17/2026	Common Stock	34,808	$0	34,808	D
Stock Options	$80.75	01/17/2017		A		34,807		01/17/2019	01/17/2026	Common Stock	34,807	$0	69,615	D
Stock Options	$80.75	01/17/2017		A		34,808		01/17/2020	01/17/2026	Common Stock	34,808	$0	104,423	D
Stock Options	$80.75	01/17/2017		A		34,807		01/17/2021	01/17/2026	Common Stock	34,807	$0	139,230	D
Stock Appreciation Rights	$80.75	01/17/2017		A		8,702		01/17/2018	01/17/2026	Common Stock	8,702	$0	8,702	D
Stock Appreciation Rights	$80.75	01/17/2017		A		8,702		01/17/2019	01/17/2026	Common Stock	8,702	$0	17,404	D
Stock Appreciation Rights	$80.75	01/17/2017		A		8,702		01/17/2020	01/17/2026	Common Stock	8,702	$0	26,106	D
Stock Appreciation Rights	$80.75	01/17/2017		A		8,702		01/17/2021	01/17/2026	Common Stock	8,702	$0	34,808	D
Stock Appreciation Rights	$90.04	01/17/2017		A		8,702		01/17/2018	01/17/2026	Common Stock	8,702	$0	8,702	D
Stock Appreciation Rights	$90.04	01/17/2017		A		8,702		01/17/2019	01/17/2026	Common Stock	8,702	$0	17,404	D
Stock Appreciation Rights	$90.04	01/17/2017		A		8,702		01/17/2020	01/17/2026	Common Stock	8,702	$0	26,106	D
Stock Appreciation Rights	$90.04	01/17/2017		A		8,702		01/17/2021	01/17/2026	Common Stock	8,702	$0	34,808	D
Stock Appreciation Rights	$100.39	01/17/2017		A		8,702		01/17/2018	01/17/2026	Common Stock	8,702	$0	8,702	D
Stock Appreciation Rights	$100.39	01/17/2017		A		8,702		01/17/2019	01/17/2026	Common Stock	8,702	$0	17,404	D
Stock Appreciation Rights	$100.39	01/17/2017		A		8,702		01/17/2020	01/17/2026	Common Stock	8,702	$0	26,106	D
Stock Appreciation Rights	$100.39	01/17/2017		A		8,702		01/17/2021	01/17/2026	Common Stock	8,702	$0	34,808	D
Stock Appreciation Rights	$111.94	01/17/2017		A		8,702		01/17/2018	01/17/2026	Common Stock	8,702	$0	8,702	D
Stock Appreciation Rights	$111.94	01/17/2017		A		8,702		01/17/2019	01/17/2026	Common Stock	8,702	$0	17,404	D
Stock Appreciation Rights	$111.94	01/17/2017		A		8,702		01/17/2020	01/17/2026	Common Stock	8,702	$0	26,106	D
Stock Appreciation Rights	$111.94	01/17/2017		A		8,702		01/17/2021	01/17/2026	Common Stock	8,702	$0	34,808	D

Explanation of Responses:

1. Annual Management Grant awarded 01/17/2017 and vesting on 01/17/2020.

2. Shares are performance-based and vest after three years upon achievement of target Company objectives.

Remarks:

	/s/ Todd M. Cleveland by Joshua A. Boone, Attorney-in-fact	01/19/2017
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.