blosser_144-110812.htm
 
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 144
 
NOTICE OF PROPOSED SALE OF SECURITIES
PURSUANT TO RULE 144 UNDER THE SECURITIES ACT OF 1933
 
ATTENTION:
Transmit for filing 3 copies of this form concurrently with either placing an order with a broker to execute sale or executing a sale directly with a market maker
 
 
 
1 (a) NAME OF ISSUER (Please type or print)
 
(b) IRS IDENT. NO.
(c) S.E.C. FILE NO.
 
 PATRICK INDUSTRIES, INC.
  35-1057796
 000-03922
 
1 (d) ADDRESS OF ISSUER
STREET
CITY
STATE
ZIP CODE
(e) TELEPHONE NO.
 107 W. FRANKLIN STREET
 
ELKHART
IN
46515
AREA CODE
NUMBER
         
574 
294-7511
2 (a) NAME OF PERSON FOR WHOSE ACCOUNT THE SECURITIES ARE TO BE SOLD
 
(b) RELATIONSHIP TO ISSUER
(c) ADDRESS STREET
CITY
STATE
ZIP CODE
 Blosser, Courtney
 
Officer
107 W. Franklin St.
Elkhart
IN
46515
 
INSTRUCTION:  The person filing this notice should contact the issuer to obtain the I.R.S. Identification Number and the S.E.C. File Number.
 
3 (a)
(b)
SEC USE ONLY
(c)
(d)
(e)
(f)
(g)
Title of the
Class of
Securities
To Be Sold
 
Name and Address of Each Broker Through Whom the
Securities are to be Offered or Each Market Maker
who is Acquiring the Securities
 
Broker-Dealer
File Number
Number of Shares
or Other Units
To Be Sold
(See instr. 3(c))
Aggregate
Market
Value
(See instr. 3(d))
Number of Shares
or Other Units
Outstanding
(See instr. 3(e))
Approximate
Date of Sale
(See instr. 3(f))
(MO.  DAY  YR.)
Name of Each
Securities
Exchange
(See instr. 3(g))
 Common Stock
ETrade Financial
1271 Avenue of the Americas
 
 7,500
$135,675 (1)
 10,522,101
 11/07/12
NASDAQ 
 
 New York, NY 10020
           
               
 
INSTRUCTIONS:

1.
(a)  Name of issuer
3.
(a) Title of the class of securities to be sold
 
(b)  Issuer’s I.R.S. Identification Number
 
(b)  Name and address of each broker through whom the securities are intended to be sold
 
(c)  Issuer’s S.E.C. file number, if any
 
(c)  Number of shares or other units to be sold (if debt securities, give the aggregate face amount)
 
(d)  Issuer’s address, including zip code
 
(d)  Aggregate market value of the securities to be sold as of a specified date within 10 days prior to the filing of this notice
 
(e)  Issuer’s telephone number, including area code
 
(e)  Number of shares or other units of the class outstanding, or if debt securities the face amount thereof outstanding, as shown by the most recent report or statement published by the issuer
2.
 (a)  Name of person for whose account the securities are to be sold
 
(f)  Approximate date on which the securities are to be sold
 
(b)  Such person’s relationship to the issuer (e.g., officer, director, 10%stockholder, or member of immediate family of any of the foregoing)
 
(g)  Name of each securities exchange, if any, on which the securities are intended to be sold
 
(c)  Such person’s address, including zip code
   
 
(d)  Such person’s address, including zip code
   
 
 
 

Explanation of Responses:
 
 
(1)
Aggregate market value is determined based on the closing stock price of Patrick Industries, Inc. common stock on November 5, 2012 of $18.09 per share.
 
 
(2)
Shares received pursuant to a stock grant awarded by the Issuer on October 1, 2009 and vesting on October 1, 2012.
 
 
 

 
 
TABLE I - SECURITIES TO BE SOLD
Furnish the following information with respect to the acquisition of the securities to be sold
and with respect to the payment of all or any part of the purchase price or other consideration therefor:
 
Title of
the Class
Date you Acquired
Nature of Acquisition Transaction
Name of Person from Whom Acquired
(If gift, also give date donor acquired)
Amount of Securities Acquired
Date of Payment
Nature of Payment
 Common Stock
(2)
(2)
Patrick Industries, Inc.
 7,500
 11/07/12
   (2)
 
INSTRUCTIONS:  If the securities were purchased and full payment therefor was not made in cash at the time of purchase, explain in the table or in a note thereto the nature of the consideration given. If the consideration consisted of any note or other obligation, or if payment was made in installments describe the arrangement and state when the note or other obligation was discharged in full or the last installment paid.
 
 
TABLE II - SECURITIES SOLD DURING THE PAST 3 MONTHS
Furnish the following information as to all securities of the issuer sold during the past 3 months by the person for whose account the securities are to be sold.
 
 
Name and Address of Seller
 
Title of Securities Sold
 
Date of Sale
Amount of
Securities Sold
 
Gross Proceeds
         
REMARKS:


INSTRUCTIONS:
See the definition of “person” in paragraph (a) of Rule 144. Information is to be given not only as to  the person for whose account the securities are to be sold but also as to all other persons included  in that definition. In addition, information shall be given as to sales by all persons whose sales are required by paragraph (e) of Rule 144 to be aggregated with sales for the account of the person filing this notice.
 
ATTENTION:  The person for whose account the securities to which this notice relates are to be sold  hereby represents by signing this notice that he does not know any material adverse information in regard to the current and prospective operations of the Issuer of the securities to be sold which has not been publiclydisclosed. If such person has adopted a written trading plan or given trading instructions to satisfy Rule 10b5-1 under the Exchange Act, by signing the form and indicating the date that the plan was adopted or the instruction given, that person makes such representation as of the plan adoption or instruction date.
 
 
 
November 7, 2012 
   
/s/ Courtney A. Blosser by Andy L. Nemeth, attorney-in-fact  
 
 DATE OF NOTICE
   
(SIGNATURE)
         
 
DATE OF PLAN ADOPTION OR GIVING OF INSTRUCTION, IF RELYING ON RULE 10B5-1
   
The notice shall be signed by the person for whose account the securities are to be sold. At least one copy of the notice shall be manually signed. Any copies not manually signed shall bear typed or printed signatures.
 
ATTENTION:  Intentional misstatements or omission of facts constitute Federal Criminal Violations (See 18 U.S.C. 1001)