-----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, SwUeg367Is1p6tSQCNseN4MKFwcXCoN3aqBJ68WUUtLfkTVIfcOsMoNGiPFZrd39 dG2HEjIS/+5zeSf6rgEupQ== 0001085762-99-000001.txt : 19991018 0001085762-99-000001.hdr.sgml : 19991018 ACCESSION NUMBER: 0001085762-99-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990930 FILED AS OF DATE: 19991007 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GREEN MOUNTAIN COFFEE 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 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-12340 FILM NUMBER: 99724729 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 COMPANY DATA: COMPANY CONFORMED NAME: COMEY PAUL CENTRAL INDEX KEY: 0001085762 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] OFFICER STATE OF INCORPORATION: VT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O GREEN MOUNTAIN COFFEE INC STREET 2: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 BUSINESS PHONE: 05676 MAIL ADDRESS: STREET 1: C/O GREEN MOUNTAIN COFFEE INC STREET 2: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 4 1 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP -------------------------------------------- Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investement Company Act of 1940 /__/ Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). 1. NAME AND ADDRESS OF REPORTING PERSON Comey Paul ----------------------------------- (LAST) (FIRST) (MIDDLE) c/o Green Mountain Coffee, Inc., 33 Coffee Lane ------------------------------------------------ (STREET) Waterbury VT 05676 ----------------------------------- (CITY) (STATE) (ZIP) 2. ISSUER NAME AND TICKER OR TRADING SYMBOL Green Mountain Coffee, Inc. - GMCR (NASDAQ) 3. IRS OR SOCIAL SECURITY NUMBER OF REPORTING PERSON (VOLUNTARY) 4. STATEMENT FOR MONTH/YEAR 9/99 5. IF AMENDMENT, DATE OF ORIGINAL (MONTH/YEAR) 6. RELATIONSHIP OF REPORTING PERSON TO ISSUER (CHECK ALL APPLICABLE) /___/ Director /_X_/ Officer (give title below) /___/ 10% Owner /___/ Other (specify below) Vice President TABLE 1 - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED 1. Title of |2. Transaction |3. Transaction |4. Securities Acquired |5. Amount of |6. Ownership Form: |7. Nature of | Security | Date | Code | (A) or Disposed of | Securities | Direct (D) or | Indirect | | | | (D) | Beneficially | Indirect (I) | Beneficial | | | | | Owned | | Ownership | | | (Instr. 8) | (Instr. 3, 4, and 5) | at End of Month | | | |----------------|-------------------------------------------| | | | (Instr. 3) |(Month/Day/Year)| Code | V | Amount |(A) or (D)| Price | (Instr. 3 and 4) | (Instr. 4) | (Instr. 4) | - -------------|----------------|--------|------|--------|----------|-------|-------------------|-------------------|--------------| GMCR Common | | | | | | | | | | Stock | 9/25/99 | J(1) | V | 91 | A | $5.95 | 13,786 | D | | - -------------|----------------|--------|------|--------|----------|-------|-------------------|-------------------|--------------|
TABLE II -- DERIVATIVE SECURITES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities) 1. Title of |2. Conversion |3. Transaction |4. Transaction |5. Number of |6. Date | Derivative | or Exercise| Date | Code | Derivative | Exercisable | Security | Price of | | | Securities | and | | Deriv- | | | Acquired (A) | Expiration | | ative | | | or Disposed | Date | | Security | | | of (D) | | | | |(Instr. 8) | (Instr. 3,4,5) |(Month/Day/Year)| | | |---------------|----------------|----------------| | | | Code | V | (A) | (D) | Date | Expir-| | | | | | | | Exer- | ation | (Instr. 3) | |(Month/Day/Year)| | | | | cisable| Date | - ----------------|--------------|----------------|--------|------|-------|--------|--------|-------| Pre-1993 Stock | | | | | | | | | Option Plan | | | | | | | | | - ----------------|--------------|----------------|--------|------|-------|--------|--------|-------| 1993 Stock | | | | | | | | | Option Plan | | | | | | | | | - ----------------|--------------|----------------|--------|------|-------|--------|--------|-------| 1999 Stock | | | | | | | | | Option Plan | | | | | | | | | - ----------------|--------------|----------------|--------|------|-------|--------|--------|-------|
7. Title and |8. Price of |9. Number of |10. Ownership |11. Nature of | Amount of | Derivative | Derivative | Form of | Indirect | Underlying | Security | Securities | Derivative | Beneficial | Securities | | Beneficially | Security: | Ownership | | | Owned at | Direct (D) | | | | End of Month | or | | (Instr. 3 and 4)| | | Indirect (I) | | - ----------------| | | | | | Amount or| | | | | | Number of| | | | | Title| Shares | (Instr. 5) | (Instr. 4) | (Instr. 4) | (Instr. 4) | - -----|----------|--------------|----------------|-----------------|---------------| | | | | | | | | | 23,574 | D | | - -----|----------|--------------|----------------|-----------------|---------------| | | | | | | | | | 11,524 | D | | - -----|----------|--------------|----------------|-----------------|---------------| | | | | | | | | | 17,500 | D | | - -----|----------|--------------|----------------|-----------------|---------------|
Explanation of Responses: (1) Shares acquired under Green Mountain Coffee, Inc.'s 1998 Employee Stock Purchase Plan /s/ Paul Comey Date: 10/5/99 - -------------------------------- ------------- **Signature of Reporting Person ** Intentional misstatements or omissions of facts constitue Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). -----END PRIVACY-ENHANCED MESSAGE-----