0001140361-12-028221.txt : 20120601 0001140361-12-028221.hdr.sgml : 20120601 20120601133236 ACCESSION NUMBER: 0001140361-12-028221 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120523 FILED AS OF DATE: 20120601 DATE AS OF CHANGE: 20120601 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fisher Cynthia A CENTRAL INDEX KEY: 0001550860 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14092 FILM NUMBER: 12882592 MAIL ADDRESS: STREET 1: 186 PARK STREET CITY: NEWTON STATE: MA ZIP: 02458 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BOSTON BEER CO INC CENTRAL INDEX KEY: 0000949870 STANDARD INDUSTRIAL CLASSIFICATION: MALT BEVERAGES [2082] IRS NUMBER: 043284048 STATE OF INCORPORATION: MA FISCAL YEAR END: 1226 BUSINESS ADDRESS: STREET 1: ONE DESIGN CENTER PLACE STREET 2: SUITE 850 CITY: BOSTON STATE: MA ZIP: 02210 BUSINESS PHONE: 617-368-5061 MAIL ADDRESS: STREET 1: ONE DESIGN CENTER PLACE STREET 2: SUITE 850 CITY: BOSTON STATE: MA ZIP: 02210 3 1 doc1.xml FORM 3 X0205 3 2012-05-23 0 0000949870 BOSTON BEER CO INC SAM 0001550860 Fisher Cynthia A 186 PARK STREET NEWTON MA 02458 1 0 0 0 Class A Common 5064 I As Trustee, in trust for children Class A Common 22756 I As Trustee, in trust under GRAT Class A Common 13145 I See Footnote Class A Common 235248 I By Spouse Class B Common 4107355 I By Spouse Class A Common 27142 I By Spouse as custodian for children under UGTMA The shares are held by West Summit Grand LLC, a limited liability company, of which the Reporting Person serves as manager. The Reporting Person expressly disclaims beneficial ownership of the securities except to the extent of her pecuniary interest therein. Cynthia A. Fisher 2012-06-01