| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF 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 | | OMB APPROVAL | | OMB Number: | 3235-0104 | | Expires: | February 28, 2011 | | Estimated average burden | | hours per response | 0.5 |
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1. Name and Address of Reporting Person*
| C/O PEETS COFFEE & TEA, INC., 1400 PARK AVENUE | |
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year)
03/04/2009 | 3. Issuer Name and Ticker or Trading Symbol
PEETS COFFEE & TEA INC
[PEET]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable) | Director | | 10% Owner | | X | Officer (give title below) | | Other (specify below) | | Vice President |
| 5. If Amendment, Date of Original Filed (Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X | Form filed by One Reporting Person | | Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Beneficially Owned |
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| 1. Title of Security (Instr.
4)
| 2.
Amount of Securities Owned (Instr.
4)
| 3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
| 4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities) |
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year)
| 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Excercise Price of Derivative Security
| 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)
| 6. Nature of Indirect Beneficial Ownership (Instr. 5)
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| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
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Option (Right to Buy)
| | 10/03/2015 |
Common Stock
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100,000
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$
30.28
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D
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Option (Right to Buy)
| | 04/10/2016 |
Common Stock
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10,536
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$
28.91
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D
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Option (Right to Buy)
| | 05/23/2017 |
Common Stock
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4,900
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$
26.5
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D
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Option (Right to Buy)
| | 05/21/2018 |
Common Stock
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6,600
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$
23.57
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D
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| Explanation of Responses: |
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| /s/ Tom Cawley, Attorney-in-Fact | 03/10/2009 |
| ** Signature of Reporting Person | Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * If the form is filed by more than one reporting person, see Instruction 5(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).
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| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see Instruction 6 for procedure. |
| 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 Number. |
EX-24
Unassociated Document
POWER
OF ATTORNEY
Know all
by these presents, that the undersigned hereby constitutes and appoints each of
Robin Riske, Tom Cawley and Ron Metzger, signing individually, the undersigned's
true and lawful attorneys-in-fact and agents to:
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(1)
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prepare,
execute in the undersigned’s name and on the undersigned’s behalf, and
submit to the U.S. Securities and Exchange Commission (the “SEC”) a Form
ID, including amendments thereto, and any other documents necessary or
appropriate to obtain codes and passwords enabling the undersigned to make
electronic filings with the SEC of reports required by Section 16(a) of
the Securities Exchange Act of 1934 or any rule or regulation of the
SEC;
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(2)
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execute
for and on behalf of the undersigned, an officer, director or holder of
10% or more of a registered class of securities of Peet’s Coffee &
Tea, Inc. (the “Company”), Forms 3, 4, and 5 in accordance with
Section 16(a) of the Securities Exchange Act of 1934, as amended (the
“Exchange Act”) and the rules
thereunder;
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(3)
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do
and perform any and all acts for and on behalf of the undersigned that may
be necessary or desirable to complete and execute such Form 3, 4, or
5, complete and execute any amendment or amendments thereto, and timely
file such forms or amendments with the United States Securities and
Exchange Commission and any stock exchange or similar authority;
and
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(4)
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take
any other action of any type whatsoever in connection with the foregoing
which, in the opinion of such attorney-in-fact, may be of benefit, in the
best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf
on behalf of the undersigned pursuant to this Power of Attorney shall be
in such form and shall contain such terms and conditions as such
attorney-in-fact may approve in such attorney-in-fact's
discretion.
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The
undersigned hereby grants to each such attorney-in-fact full power and authority
to do and perform any and every act and thing whatsoever requisite, necessary,
or proper to be done in the exercise of any of the rights and powers herein
granted, as fully to all intents and purposes as the undersigned might or could
do if personally present, with full power of substitution or revocation, hereby
ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing
attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming, not is the Company assuming, any of the
undersigned’s responsibilities to comply with Section 16 of the Exchange
Act.
This
Power of Attorney shall remain in full force and effect until the earliest to
occur of (a) the undersigned is no longer required to file Forms 3, 4, and
5 with respect to the undersigned's holdings of and transactions in securities
issued by the Company, (b) revocation by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact or (c) as to any attorney-in-fact
individually, until such attorney-in-fact shall no longer be employed by the
Company or Cooley Godward Kronish llp.
IN
WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 4th day of
March, 2009.
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/s/ P. Christine
Lansing
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P.
Christine Lansing
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