-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KlemazmdTk7zNZVHEEwhPcl4Hk0iuQgknxBqjQyTlvbbwS+G7W4RSJ7shSR/5rPL daqfbWj4Xars784YRrOt9w== 0000909954-04-000031.txt : 20040601 0000909954-04-000031.hdr.sgml : 20040601 20040601103034 ACCESSION NUMBER: 0000909954-04-000031 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040528 FILED AS OF DATE: 20040601 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GREEN MOUNTAIN COFFEE ROASTERS INC CENTRAL INDEX KEY: 0000909954 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS FOOD PREPARATIONS & KINDRED PRODUCTS [2090] IRS NUMBER: 030339228 STATE OF INCORPORATION: DE FISCAL YEAR END: 0928 BUSINESS ADDRESS: STREET 1: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 BUSINESS PHONE: 8022445621 MAIL ADDRESS: STREET 1: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 FORMER COMPANY: FORMER CONFORMED NAME: GREEN MOUNTAIN COFFEE INC DATE OF NAME CHANGE: 19930729 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PREVO JAMES K CENTRAL INDEX KEY: 0001096214 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS FOOD PREPARATIONS & KINDRED PRODUCTS [2090] STATE OF INCORPORATION: DE FISCAL YEAR END: 0928 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12340 FILM NUMBER: 04839980 BUSINESS ADDRESS: STREET 1: C/O GREEN MOUNTAIN COFFEE INC STREET 2: 33 COFFEE LN CITY: WATERBURY STATE: VT ZIP: 05676 BUSINESS PHONE: 8022445621 MAIL ADDRESS: STREET 1: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 4 1 primary_doc.xml PRIMARY DOCUMENT X0202 4 2004-05-28 0 0000909954 GREEN MOUNTAIN COFFEE ROASTERS INC GMCR 0001096214 PREVO JAMES K 33 COFFEE LANE WATERBURY VT 05676 0 1 0 0 CIO gmcr common stock 2004-05-28 4 M 0 2000 2.813 A 10804.95 D gmcr common stock 2004-05-28 4 S 0 2000 20 D 8804.95 D gmcr option to buy common stock 2.813 2004-05-28 4 M 0 2000 0 D 2003-01-08 2009-01-08 GMCR Common Stock 2000 20000 D /s/ James K. Prevo 2004-06-01 -----END PRIVACY-ENHANCED MESSAGE-----