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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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Schedule 13G
(Rule 13d-102)
Information to be Included in Statements Filed Pursuant
to Rules 13d-1(b) and (c) and Amendments Thereto Filed
Pursuant to 13d-2(b)
(Amendment No. __)(1)
RUBIO'S RESTAURANTS, INC.
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(Name of Issuer)
COMMON STOCK, PAR VALUE $.001 PER SHARE
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(Title of Class of Securities)
78116B102
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(CUSIP Number)
DECEMBER 31, 1999
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(Date of Event which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule
is filed:
|_| Rule 13d-1(b)
|_| Rule 13d-1(c)
|X| Rule 13d-1(d)
(CONTINUED ON FOLLOWING PAGE(S))
(Page 1 of 6 Pages)
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1 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 the disclosures provided in a prior cover page.
The information required in 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 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).
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CUSIP NO. 13G Page 2 of 6 Pages
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1. NAMES OF REPORTING PERSONS
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)
Rafael Rubio
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2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) |_|
(b) |_|
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3. SEC USE ONLY
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4. CITIZENSHIP OR PLACE OF ORGANIZATION United States.
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5. SOLE VOTING POWER
NUMBER 800,000 (1)
OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON -----------------------------------------------
WITH 6. SHARED VOTING POWER
-0-
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7. SOLE DISPOSITIVE POWER
800,000 (1)
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8. SHARED DISPOSITIVE POWER
-0-
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9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
800,000 (1)
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10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
| |
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11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
9.0% as of February 14, 2000
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12. TYPE OF REPORTING PERSON*
IN
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(1) All of the above shares are held by the Rafael K. Rubio and Gloria G. Rubio
Family Trust.
*SEE INSTRUCTIONS BEFORE FILLING OUT!
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ITEM 1(a). NAME OF ISSUER:
Rubio's Restaurants, Inc.
ITEM 1(b). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES:
1902 WRIGHT PLACE, SUITE 300
CARLSBAD, CA 92008
ITEM 2(a). NAME OF PERSON FILING:
Rafael Rubio
ITEM 2(b). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE:
1902 WRIGHT PLACE, SUITE 300
CARLSBAD, CA 92008
ITEM 2(c). CITIZENSHIP:
United States
ITEM 2(d). TITLE OF CLASS OF SECURITIES:
Common Stock, par value $.001 per share
ITEM 2(e). CUSIP NUMBER: 78116B102
ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULE 13d-1(b),
OR 13D-2(b), CHECK WHETHER THE PERSON FILING IS A:
Not Applicable.
ITEM 4. OWNERSHIP.
(a) Amount Beneficially Owned: See Row 9 of cover page.
(b) Percent of Class: See Row 11 of cover page.
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(c) Number of Shares as to which such person has:
(i) sole power to vote or to direct the vote: See Row 5
of cover page.
(ii) shared power to vote or to direct the vote: -0-.
(iii) sole power to dispose or to direct the disposition
of: See Row 7 of cover page.
(iv) shared power to dispose or to direct the disposition
of: -0-
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ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS.
If this statement is being filed to report the fact that
as of the date hereof the reporting person has ceased to
be the beneficial owner of more than five percent of the
class of securities, check the following .
ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER
PERSON.
Not Applicable.
ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH
ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT
HOLDING COMPANY.
Not Applicable.
ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP.
Not Applicable.
ITEM 9. NOTICE OF DISSOLUTION OF GROUP.
Not Applicable.
ITEM 10. CERTIFICATIONS.
Not Applicable.
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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.
Date: February 14, 2000
/s/ RAFAEL RUBIO
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Rafael Rubio
