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