0000909954-11-000085.txt : 20111117 0000909954-11-000085.hdr.sgml : 20111117 20111117153757 ACCESSION NUMBER: 0000909954-11-000085 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111117 FILED AS OF DATE: 20111117 DATE AS OF CHANGE: 20111117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DAFT DOUGLAS N CENTRAL INDEX KEY: 0001019420 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12340 FILM NUMBER: 111213009 MAIL ADDRESS: STREET 1: C/O GREEN MOUNTAIN COFFEE 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 X0304 4 2011-11-17 0 0000909954 GREEN MOUNTAIN COFFEE ROASTERS INC GMCR 0001019420 DAFT DOUGLAS N C/O GREEN MOUNTAIN COFFEE 33 COFFEE LANE WATERBURY VT 05676 1 0 0 0 GMCR Common Stock 2011-11-17 4 P 0 4000 54.452 A 4000 D /s/ Valerie Jennings pursuant to a Power of Attorney 2011-11-17