-----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, Sta/KI20XE243AGop/8KdyryNKu2HCCHy/B7ITAr22c1xcw6HztqS8ppZrMyX3ji Hzo7RtgAPvUm2PyvZNUkkw== 0000909954-05-000045.txt : 20051003 0000909954-05-000045.hdr.sgml : 20051003 20051003153621 ACCESSION NUMBER: 0000909954-05-000045 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050930 FILED AS OF DATE: 20051003 DATE AS OF CHANGE: 20051003 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: DAVIS WILLIAM D CENTRAL INDEX KEY: 0001224777 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12340 FILM NUMBER: 051117467 BUSINESS ADDRESS: BUSINESS PHONE: 8022445621 MAIL ADDRESS: STREET 1: C/O GREEN MOUNTAIN COFFEE ROASTERS INC STREET 2: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 4 1 primary_doc.xml PRIMARY DOCUMENT X0202 4 2005-09-30 0 0000909954 GREEN MOUNTAIN COFFEE ROASTERS INC gmcr 0001224777 DAVIS WILLIAM D C/O GREEN MOUNTAIN COFFEE ROASTERS INC 33 COFFEE LANE WATERBURY VT 05676 1 0 0 0 GMCR Phantom Stock Units 2005-09-30 4 A 0 230.02 34.78 A 2005-09-30 GMCR Common Stock 230.02 1606.13 D 1 for 1 On 9/30/05, Mr. Davis acquired 230.02 phantom stock units at a price of $34.78 as result of fee deferral. Distributions are made under the Deferred Compensation Plan at the time of the participant's death, disability or termination of services. /s/ William D. Davis 2005-10-03 -----END PRIVACY-ENHANCED MESSAGE-----