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| FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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: | 3235-0287 | | Expires: | February 28, 2011 | | Estimated average burden | | hours per response | 0.5 |
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| | Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)| NORTH BROOKLYN CENTER | MN | 55249 |
| 2. Issuer Name and Ticker or Trading Symbol
Caribou Coffee Company, Inc.
[CBOU] | 5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)| X | Director | | 10% Owner | | Officer (give title below) | | Other (specify below) | |
| 3. Date of Earliest Transaction (Month/Day/Year)
08/27/2008 | 4. If Amendment, Date of Original Filed (Month/Day/Year)
| 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 Acquired, Disposed of, or Beneficially Owned | 1.Title of Security
(Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code
(Instr. 8) | 4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) | 7. Nature of Indirect Beneficial Ownership
(Instr. 4) | | Code | V | Amount | (A) or (D) | Price | |
Common Stock
| 08/27/2008 | | P | |
2,250
| A | $
3.09
|
6,250
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D
| | |
Common Stock
| 08/27/2008 | | P | |
300
| A | $
3.1
|
6,550
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D
| | |
Common Stock
| 08/27/2008 | | P | |
1,480
| A | $
3.11
|
8,030
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D
| | |
Common Stock
| 08/27/2008 | | P | |
4,375
| A | $
3.12
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12,405
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D
| | |
Common Stock
| 08/27/2008 | | P | |
650
| A | $
3.13
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13,055
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D
| | |
Common Stock
| 08/27/2008 | | P | |
300
| A | $
3.14
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13,355
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D
| | |
Common Stock
| 08/27/2008 | | P | |
645
| A | $
3.15
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14,000
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D
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities) | 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) | | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Explanation of Responses: |
| Dan E. Lee | 08/28/2008 | | ** 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 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).
| | 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. |
WHEREAS, pursuant to the Securities Act of 1933, as amended, and Section 16 of
the Securities Exchange Act of 1934, the undersigned intends to file Form ID and
Forms 3, 4 and/or 5 (the "Forms") with the Securities
and Exchange Commission and the Nasdaq Stock Market when and if such Forms are
required to be filed.
NOW, THEREFORE the undersigned hereby appoints each of Michael E.
Peterson, Vice President of Caribou Coffee Company, Inc. (the "Company"), and
Dan Lee, General Counsel of the Company his/her true and lawful attorney to
execute in her name, place and stead, said Forms and any and all amendments to
said Forms and all instruments necessary or incidental in connection therewith,
and to file the same with the Securities and Exchange Commission and the Nasdaq
Stock Market. Each said attorney individually shall have full power and
authority to do and perform in the name and on behalf of the undersigned, in any
and all capacities, every act whatsoever necessary or desirable to be done in
the premises, as fully to all intents and purposes as the undersigned might or
could do in person. This Power of Attorney shall continue in full force and
effect for so long as the undersigned is a Section 16 Reporting Person of the
Company and required to file Forms with the Securities and Exchange Commission
as a result thereof. This Power of Attorney supersedes any previous power of
attorney executed by the undersigned with respect to the subject matter hereof.
IN WITNESS WHEREOF, the undersigned has executed this instrument on September
27,2005.
/s/ Kip R. Caffey
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