Amended Statement of Ownership (sc 13g/a)
April 28 2014 - 1:30PM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE
ACT OF 1934
(AMENDMENT NO. 12)*
Keurig Green Mountain, Inc.
(Name of Issuer)
Common Stock, $0.10 par value
(Title of Class of Securities)
393122106
(CUSIP Number)
March 24, 2014
(Date of Event Which Requires
Filing of this Statement)
Check the appropriate box to designate the rule pursuant
to which this Schedule is filed:
*
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The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.
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The information required on the remainder of this cover
page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”)
or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however,
see the Notes).
1
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NAME OF REPORTING PERSONS
I.R.S. IDENTIFICATION NO. OF
ABOVE PERSONS (ENTITIES ONLY)
Robert P. Stiller
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2
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(a)
☐
(b)
☐
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3
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SEC USE ONLY
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4
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CITIZENSHIP OR PLACE OF ORGANIZATION
United States
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NUMBER OF
SHARES
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5
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SOLE VOTING POWER
11,956,716 (includes presently exercisable employee
stock options to acquire 845,273 shares of Common Stock, and 2,802,600 shares of Common Stock issuable upon exercise of Call Options)
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BENEFICIALLY
OWNED BY
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6
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SHARED VOTING POWER
72,178 (includes 60,128 shares of Common Stock held
by an entity controlled by a family trust, and 12,050
shares of Common Stock held by Mr. Stiller’s
charitable foundation)
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EACH
REPORTING
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7
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SOLE DISPOSITIVE POWER
11,956,716 (includes presently exercisable employee
stock options to acquire 845,273 shares of Common Stock, and 2,802,600 shares of Common Stock issuable upon exercise of Call Options)
|
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PERSON
WITH
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8
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SHARED DISPOSITIVE POWER
72,178 (includes 60,128 shares of Common Stock held
by an entity controlled by a family trust, and 12,050
shares of Common Stock held by Mr. Stiller’s
charitable foundation)
|
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9
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING
PERSON
12,028,894 (includes presently exercisable employee
stock options to acquire 845,273 shares of Common Stock, 60,128 shares of Common Stock held by an entity controlled by a family
trust, 12,050
shares of Common Stock held by Mr. Stiller’s charitable foundation and 2,802,600
shares of Common Stock issuable upon exercise of Call Options)
|
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10
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CHECK BOX IF THE AGGREGATE AMOUNT
IN ROW (9) EXCLUDES
CERTAIN SHARES
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[
]
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11
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
7.43% (calculation based on 161,796,274 shares outstanding
as of March 18, 2014, as disclosed in the Issuer’s 8-K, filed March 31, 2014)
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12
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TYPE OF REPORTING PERSON
IN
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Keurig Green
Mountain, Inc.
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(b)
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ADDRESS
OF ISSUER’S PRINCIPAL EXECUTIVE OFFICES
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33 Coffee
Lane, Waterbury, VT 05676
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(a)
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NAME
OF PERSON FILING
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Robert P.
Stiller
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(b)
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ADDRESS
OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE
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c/o Sunrise
Management Services, LLC, 180 Battery Street, Suite 250, Burlington, VT 05401
United States
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(d)
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TITLE
OF CLASS OF SECURITIES
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Common Stock,
$0.10 par value per share
393122106
ITEM 3.
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IF
THIS STATEMENT IS FILED PURSUANT TO SECTIONS 240.13d-1(b) OR 240.13d-2(b) or (c), CHCK WHETHER THE PERSON FILING IS:
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Not Applicable
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(a)
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Amount
beneficially owned:
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12,028,894 (includes
presently exercisable employee stock options to acquire 845,273 shares of Common Stock, 60,128 shares of Common Stock held by
an entity controlled by a family trust, 12,050 shares of Common Stock held by Mr. Stiller’s charitable foundation and 2,802,600
shares of Common Stock issuable upon exercise of Call Options)
7.43% (calculation
based on 161,796,274 shares outstanding as of March 18, 2014, as disclosed in the Issuer’s 8-K, filed March 31, 2014)
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(c)
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Number
of shares as to which the person has:
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(i)
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Sole
power to direct the vote:
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11,956,716 (includes
presently exercisable employee stock options to acquire 845,273 shares of Common Stock, and 2,802,600 shares of Common Stock issuable
upon exercise of Call Options)
|
(ii)
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Shared
power to direct the vote:
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72,178 (includes
60,128 shares of Common Stock held by an entity controlled by a family trust, and 12,050 shares of Common Stock held by Mr. Stiller’s
charitable foundation)
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(iii)
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Sole
power to dispose or to direct the disposition of:
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11,956,716 (includes
presently exercisable employee stock options to acquire 845,273 shares of Common Stock, and 2,802,600 shares of Common Stock issuable
upon exercise of Call Options)
|
(iv)
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Shared
power to dispose or to direct the disposition of:
|
72,178 (includes
60,128 shares of Common Stock held by an entity controlled by a family trust, and 12,050 shares of Common Stock held by Mr. Stiller’s
charitable foundation)
ITEM 5.
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OWNERSHIP
OF FIVE PERCENT OR LESS OF A CLASS
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Not Applicable
ITEM 6.
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OWNERSHIP
OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON
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Not Applicable
ITEM 7.
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IDENTIFICATION
AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY
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Not Applicable
ITEM 8.
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IDENTIFICATION
AND CLASSIFICATION OF MEMBERS OF THE GROUP
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Not Applicable
ITEM 9.
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NOTICE
OF DISSOLUTION OF GROUP
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Not Applicable
By signing
below I certify that to the best of my knowledge and belief, the securities referred to above were not acquired and are not held
for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired
and are not held in connection with or as a participant in any transaction having that purpose.
SIGNATURE
After reasonable inquiry
and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
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April
24, 2014
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Date
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/s/Robert
P. Stiller
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Signature
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Robert
P. Stiller
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Name
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Keurig Green Mountain, Inc. (NASDAQ:GMCR)
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