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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Restricted Stock Units | (1) | 12/01/2015 | M | 213 | (2) | (2) | Common Stock | 213 | (1) | 424 | D | ||||
NQ Stock Options | $ 52.98 | 12/01/2015 | A | 5,020 | (5) | 12/01/2025 | Common Stock | 5,020 | (6) | 5,020 | D | ||||
Restricted Stock Units | (7) | 12/01/2015 | A | 1,673 | (8) | (8) | Common Stock | 1,673 | $ 0 | 1,673 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Gibbs Stephen L 33 COFFEE LANE WATERBURY, VT 05676 |
VP, Chief Accounting Officer |
/s/ Jessica H. Collins, pursuant to a Power of Attorney | 12/03/2015 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The reporting person had vested restricted stock units settled in shares of common stock par value $0.10, of Keurig Green Mountain, Inc. (the "Company"). |
(2) | On December 1, 2014 the reporting person was granted 637 restricted stock units which vest in three equal installments. Each restricted stock unit represents a contingent right to receive one share of the Company's common stock ("Common Stock"). 213 of the restricted units vested on December 1, 2015. |
(3) | This number represents shares of Common Stock sold to satisfy the tax obligation due upon vesting of the restricted stock units. |
(4) | This transaction was executed in multiple trades at prices ranging from $53.06 to $53.26. The price reported above reflects the weighted average sales price. The reporting person hereby undertakes to provide upon request to the SEC Staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. |
(5) | Options vest in three equal annual installments, with the first installment vesting December 1, 2016, the first anniversary of the grant date. |
(6) | 1 for 1. |
(7) | Each restricted stock unit represents a contingent right to receive one share of Common Stock. The price of a share of the Company's stock on the date of grant was $52.98. |
(8) | The restricted stock units vest in three equal annual installments, with the first installment vesting on December 1, 2016. |