SEC Form 4 · accession 0001179110-15-001605
KEURIG GREEN MOUNTAIN, INC. · GMCR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John D Hayes
Director
Period of report
Jan 30, 2015
Accepted (ET)
Feb 3, 2015 · 5:36 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000909954
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom Stock UnitsF1,F2,F3 | — | Jan 30, 2015 | M | 979 | A | — | — | Common Stock | 979 | 979 | D |
| Phantom Stock UnitsF1,F4,F3 | — | Jan 30, 2015 | M | 24 | A | — | — | Common Stock | 24 | 1,003 | D |
Explanation of responses
- F1Each share of Phantom Stock Units is the economic equivalent of one share of Common Stock.
- F2On 1/30/2015 the reporting person acquired 979 units of Phantom Stock at a unit price of $122.56 as a result of a deferral of restricted stock units granted to him on 1/30/2015. The restricted stock units fully vested on the date of grant.
- F3Distribution is made under the Keurig Green Mountain 2002 Deferred Compensation Plan, as amended, on a fixed date, or at the time of the participants death, disability, or termination of service.
- F4On 1/30/2015 the reporting person acquired 24 units of Phantom Stock at a unit price of $122.56 as a result of a fee deferral.