UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM SD

 

 

Specialized Disclosure Report

 

KEURIG GREEN MOUNTAIN, INC.

(Exact name of registrant as specified in its charter)

 

 

Delaware

 

1-12340

 

03-0339228

(State or other jurisdiction
of incorporation or organization)

 

(Commission
File Number)

 

(I.R.S. Employer

Identification Number)

 

33 Coffee Lane, Waterbury, Vermont 05676

(Address of registrant’s principal executive office) (Zip Code)

 

Michael J. Degnan
(781) 418-3120

(Name and telephone number, including area code, of person to contact in connection with this report)

 

 

Check the appropriate box to indicate the rule pursuant to which this form is being filed, and provide the period to which the information in this applies:

 

x          Rule 13p-1 under the Securities Exchange Act (17 CFR 240.13p-1) for the reporting period from January 1 to December 31, 2013

 

 

 


 

Section 1 — Conflict Minerals Disclosure

 

Item 1.01  Conflict Minerals Disclosure and Report

 

Conflict Minerals Disclosure

 

This Form SD of Keurig Green Mountain, Inc. (the “Company”) is filed pursuant to Rule 13p-1 promulgated under the Securities Exchange Act of 1934, as amended, for the reporting period January 1, 2013 to December 31, 2013.

 

A copy of the Company’s Conflict Minerals Report is provided as Exhibit 1.02 to this Form SD, and is publicly available at http://www.keuriggreenmountain.com/Sustainability/ReportsAndDisclosures/ConflictMinerals.aspx.

 

Item 1.02  Exhibit

 

As specified in Section 2, Item 2.01 of this Form SD, the Company is hereby filing its Conflict Minerals Report as Exhibit 1.02 to this report.

 

Section 2 — Exhibits

 

Item 2.01  Exhibits

 

The following exhibit is filed as part of this report.

 

Exhibit No.

 

Description

1.02

 

Conflict Minerals Report of Keurig Green Mountain, Inc.

 

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SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the duly authorized undersigned.

 

KEURIG GREEN MOUNTAIN, INC.

 

By:

/s/ Robert P. Ostryniec

 

May 30, 2014

 

Robert P. Ostryniec

 

(Date)

 

Chief Product Supply Officer

 

 

 

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EXHIBIT INDEX

 

Exhibit No.

 

Description

1.02

 

Conflict Minerals Report of Keurig Green Mountain, Inc.

 

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