SEC Form 3
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*
MORTENSEN THOMAS W

(Last) (First) (Middle)
20333 S. NORMANDIE AVE.

(Street)
TORRANCE CA 90502

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/28/2012
3. Issuer Name and Ticker or Trading Symbol
FARMER BROTHERS CO [ FARM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SR. VICE PRES.OF ROUTE SALES
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 $1 par value 1,308 D
Common Stock $1 par value 6,948(1) I Held in Employee Stock Ownership Plan.
Common Stock $1 par value 465(2) D
Common Stock $1 par value 465(3) D
Common Stock $1 par value 1,070(4) 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
Stock Option (right to buy) (5) 02/20/2015 Common Stock 3,000 $22.7 D
Stock Option (right to buy) (6) 12/11/2015 Common Stock 3,000 $21.76 D
Stock Option (right to buy) (7) 12/10/2016 Common Stock 3,035 $18.41 D
Stock Option (right to buy) (8) 12/09/2017 Common Stock 3,035 $18.03 D
Stock Option (right tobuy) (9) 12/08/2018 Common Stock 3,035 $7.32 D
Explanation of Responses:
1. Shares that have been allocated to the reporting person as of the date of this filing pursuant to the Employee Stock Ownership Plan.
2. Restricted stock granted to reporting person on December 10, 2009 under the 2007 Omnibus Plan; 100% of the shares will vest on December 10, 2012, subject to acceleration provisions of the 2007 Omnibus Plan and restricted stock agreement.
3. Restricted stock granted to reporting person on December 9, 2010 under the 2007 Omnibus Plan; 100% of the shares will vest on December 9, 2013, subject to acceleration provisions of the 2007 Omnibus Plan and restricted stock agreement.
4. Restricted stock granted to reporting person on December 8, 2011 under the 2007 Omnibus Plan; 100% of the shares will vest on December 8, 2014, subject to acceleration provisions of the 2007 Omnibus Plan and restricted stock agreement.
5. Non-qualified stock option granted to reporting person on February 20, 2008, which stock option vested fully on February 20, 2011. 100% of the shares are vested and exercisable as of the date of this filing.
6. Non-qualified stock option granted to reporting person on December 11, 2008, which stock option vested fully on December 11, 2011. 100% of the shares are vested and exercisable as of the date of this filing.
7. Non-qualified stock option granted to reporting person on December 10, 2009. The stock option vests pursuant to a three year vesting schedule, whereby one-third of the total number of shares issuable under the option becomes exercisable each year on the anniversary of the grant date, commencing on December 10, 2009, subject to the acceleration provisions of the 2007 Omnibus Plan and stock option agreement. As of the date of this filing, 2,023 shares are vested and exercisable.
8. Non-qualified stock option granted to reporting person on December 9, 2010. The stock option vests pursuant to a three year vesting schedule, whereby one-third of the total number of shares issuable under the option becomes exercisable each year on the anniversary of the grant date, commencing on December 9, 2010, subject to the acceleration provisions of the 2007 Omnibus Plan and stock option agreement. As of the date of this filing, 1,011 shares are vested and exercisable.
9. Non-qualified stock option granted to reporting person on December 8, 2011. The stock option vests pursuant to a three year vesting schedule, whereby one-third of the total number of shares issuable under the option becomes exercisable each year on the anniversary of the grant date, commencing on December 8, 2011, subject to the acceleration provisions of the 2007 Omnibus Plan and stock option agreement. As of the date of this filing, none of the shares is vested and exercisable.
Remarks:
Exhibit 24. Power of Attorney attached.
/s/ Larry B. Garrett, Attorney-In-Fact 04/03/2012
** 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 5 (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.