SEC Form 4/A · accession 0001179110-15-003432

KEURIG GREEN MOUNTAIN, INC. · GMCR

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

This is an amendment (Form 4/A). It replaces an earlier filing for the same period.

Reporting owner

Director

Period of report

Jan 1, 2015

Accepted (ET)

Feb 25, 2015 · 5:18 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000909954

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F3,F2	Jan 1, 2015	M	220	$0.00	A	15,895	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Phantom Stock Units^F1,F5,F3,F4	—	Jan 1, 2015	M	220	D	—	—	Common Stock	220	30,636	D

F1The original Form 4 filed on January 5, 2015 (the "Original Form 4") incorrectly reported, due to administrative error, the number of Phantom Stock Units settled on January 1, 2015. This Form 4/A amends the Original Form 4 to correct the number of Phantom Stock Units settled on January 1, 2015 from 3,467 to 220.
F2Reflects the reporting person's beneficial ownership as of the date of the filing of the Original Form 4. This amount does not include the 979 shares of Common Stock acquired by the reporting person upon the January 30, 2015 grant of fully vested restricted stock units by the Company to the reporting person, which were reported on a Form 4 filed by the reporting person on February 3, 2015.
F3Each Phantom Stock Unit is the economic equivalent of one share of Common Stock.
F4The Phantom Stock Units were granted to the reporting person under the Company's 2002 Deferred Compensation Plan, as amended. This Form 4/A is being filed to report the settlement on January 1, 2015 of 220 Phantom Stock Units for shares of Common Stock pursuant to the reporting person's previously made election to defer.
F5Reflects the reporting person's beneficial ownership as of the date of the filing of the Original Form 4.