0001104659-12-052900.txt : 20120731
0001104659-12-052900.hdr.sgml : 20120731
20120731215406
ACCESSION NUMBER: 0001104659-12-052900
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120727
FILED AS OF DATE: 20120731
DATE AS OF CHANGE: 20120731
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Isely Lucas
CENTRAL INDEX KEY: 0001554585
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35608
FILM NUMBER: 12998279
MAIL ADDRESS:
STREET 1: C/O NATURAL GROCERS BY VITAMIN COTTAGE
STREET 2: 12612 W. ALAMEDA PARKWAY
CITY: LAKEWOOD
STATE: CO
ZIP: 80228
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Natural Grocers by Vitamin Cottage, Inc.
CENTRAL INDEX KEY: 0001547459
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411]
IRS NUMBER: 841444517
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 12612 W. ALAMEDA PARKWAY
CITY: LAKEWOOD
STATE: CO
ZIP: 80228
BUSINESS PHONE: 800-817-9415
MAIL ADDRESS:
STREET 1: 12612 W. ALAMEDA PARKWAY
CITY: LAKEWOOD
STATE: CO
ZIP: 80228
4
1
a4.xml
4
X0306
4
2012-07-27
0
0001547459
Natural Grocers by Vitamin Cottage, Inc.
NGVC
0001554585
Isely Lucas
C/O NATURAL GROCERS BY VITAMIN COTTAGE
12612 W. ALAMEDA PARKWAY
LAKEWOOD
CO
80228
0
0
0
1
13D Group Member
Common Stock
2012-07-27
5
J
0
E
51872
A
51872
D
Common Stock
2012-07-27
5
J
0
E
129057
A
129057
I
By The LaRock and Luke Isely Trust
Common Stock
2012-07-30
5
S
0
E
37119
15
D
91338
I
By The LaRock and Luke Isely Trust
Common Stock
2012-07-27
5
J
0
E
1204100
A
1204100
I
By CTVC, LLC
Common Stock
2012-07-30
5
S
0
E
166161
15
D
1037939
I
By CTVC, LLC
Common Stock
2012-07-27
5
J
0
E
627800
A
627800
I
By FTVC, LLC
Common Stock
2012-07-30
5
S
0
E
55950
15
D
571850
I
By FTVC, LLC
Common Stock
2012-07-27
5
J
0
E
37717
A
37717
I
By EIVC 1, LLC
Common Stock
2012-07-27
5
J
0
E
295249
A
295249
I
By EIVC 2, LLC
Shares were acquired by the direct beneficial owner in a redomestication, holding company reorganization exempt from Section 16(b) of the Securities Exchange Act of 1934, as amended, under Rule 16b-7 promulgated thereunder. In connection with, and immediately prior to the completion of, the issuer's initial public offering, the then existing shareholders of Vitamin Cottage Natural Food Markets, Inc. (now the issuer's wholly-owned subsidiary and operating company) exchanged their shares of capital stock in the operating company for a ratable percentage of shares of common stock of the issuer.
Reporting person is a beneficiary, but has no investment power over these shares and disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
Reporting person is a beneficiary through a member trust, but has no investment power over these shares and disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
The Reporting Person is a party to a Stockholders Agreement entered into in connection with the reorganization transaction that contains voting agreements and thus is a member of a Schedule 13D group that beneficially owns more than 10% of the issuer's common stock.
/s/ Kemper Isely, by Power of Attorney
2012-07-31