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Form 3 PATRICK INDUSTRIES INC For: May 12 Filed by: Neu Stacey L

June 24, 2022 9:35 PM EDT

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FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person *
Neu Stacey L

(Last) (First) (Middle)
107 W. FRANKLIN STREET

(Street)
ELKHART IN 46515

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/12/2022
3. Issuer Name and Ticker or Trading Symbol
PATRICK INDUSTRIES INC [ PATK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP & CHRO
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 3,710 (1)
D
 
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Represents the aggregate of time-based and performance-based awards granted to the reporting person by the Issuer.
/s/ Stacey L. Neu by Jacob R. Petkovich, attorney-in-fact 06/24/2022
** 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.
POWER OF ATTORNEY The undersigned constitutes and appoints Andy L. Nemeth, Jacob R. Petkovich and Julie Ann Kotowski and each of them, as the undersigned's true and lawful attorneys-in-fact and agents, with full power of substitution and re-substitution, for the undersigned and in the undersigned's name, place and stead, to sign any and all (1) Form 144s under the Securities Act of 1933 and (2) Securities and Exchange Commission statements of beneficial ownership of securities of Patrick Industries, Inc. ("Company") on Forms 3, 4 and 5 as required under Section 16(a) of the Securities Exchange Act of 1934, and to file the same with all exhibits thereto, and other documents in connection therewith, with the Securities and Exchange Commission, the Company and the Financial Industry Regulatory Authority, Inc., granting unto said attorneys-in­ fact and agents, and each of them, full power and authority to do and perform each act and thing requisite and necessary to be done under said Rule 144 and Section 16(a), as fully and to all intents and purposes as the undersigned might or could do in person, hereby ratifying and confirming all that said attorneys-in-fact and agents, and each of them, may lawfully do or cause to be done by virtue hereof. A copy of this power of attorney shall be filed with the Securities and Exchange Commission. The authorization set forth above shall continue in full force and effect until the undersigned revokes such authorization by written instructions to the attorneys-in-fact. The authority granted hereby shall in no event be deemed to impose or create any duty on behalf of the attorneys-in-fact with respect to the undersigned's obligations to file Form 144 or Forms 3, 4 and 5 with the Securities and Exchange Commission. Dated: .5 /-z. :s / 2.o 2.L Signature of Reporting Person: Name: Title: Name: laced here: KARLY LEININGER Hot1ry Public · Seal Elkhart County· 5tilte of lndlillht Commission Numb~r NP0656940 My Commission EllitiresAug 17, 2022


 


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