0000909954-12-000005.txt : 20120110 0000909954-12-000005.hdr.sgml : 20120110 20120110130650 ACCESSION NUMBER: 0000909954-12-000005 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120109 FILED AS OF DATE: 20120110 DATE AS OF CHANGE: 20120110 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McCreary Richard Scott CENTRAL INDEX KEY: 0001304561 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12340 FILM NUMBER: 12519382 MAIL ADDRESS: STREET 1: 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 2012-01-09 0 0000909954 GREEN MOUNTAIN COFFEE ROASTERS INC GMCR 0001304561 McCreary Richard Scott 33 COFFEE LANE WATERBURY VT 05676 0 1 0 0 President, SCBU GMCR Common Stock 2012-01-09 4 M 0 20000 1.47 A 153154 D GMCR Stock Option 1.47 2012-01-09 4 M 0 20000 D 2014-09-25 GMCR Common Stock 20000 103240 D Grant vest in four equal annual installments, with the first installment vesting on the first anniversary of the grant date, 9/25/2005 1 for 1 /s/ Valerie Jennings pursuant to a Power of Attorney 2012-01-10