0000909954-11-000039.txt : 20110503 0000909954-11-000039.hdr.sgml : 20110503 20110503121455 ACCESSION NUMBER: 0000909954-11-000039 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110429 FILED AS OF DATE: 20110503 DATE AS OF CHANGE: 20110503 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: 11803797 MAIL ADDRESS: STREET 1: C/O GREEN MOUNTAIN COFFEE ROASTERS INC STREET 2: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 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: 0929 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 4 1 primary_doc.xml PRIMARY DOCUMENT X0303 4 2011-04-29 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 2011-04-29 4 A 0 29.87 66.96 A 2011-04-29 Common stock 29.87 33020 D 1 for 1 On 4/29/2011, Mr. Davis acquired 29.87 units of phantom stock at a unit price of $66.96 as a result of fee deferral. Distribution is made under the Deferred Compensation Plan at the time of the participant's death, disability, or termination of services. /s/ Valerie Jennings pursuant to a power of attorney 2011-05-03