U. S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
FORM 4
1. Name and Address of Reporting Person:
James Osborn
110 Veterans Blvd., Suite 222
Metairie, Louisiana 70005
2. Issuer Name and Ticker or Trading Symbol:
Cucos Inc. - CUCO
3. IRS or Social Security Number of Reporting Person
(Voluntary):
SS# ###-##-####
4. Statement for Month/Year: January, 2000
5. If Amendment, Date of Original (Month/Year): N/A
6. Relationship of Reporting Person to Issuer:
President, Chief Executive Officer, and Director
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned.
1. Title of Security (Inst. 3): None
2. Transaction Date (Month/Day/Year):
3. Transaction Code (Instr. 8):
Code:
V:
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and
5):
Amount:
(A) or (D):
Price:
5. Amount of Securities Beneficially Owned at End of Month
(Instr. 3 and 4):
100 Shares Common Stock
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4): D
7. Nature of Indirect Beneficially Ownership (Instr. 4):
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned(e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security (Inst. 3):
1. Stock Options (to buy)
2. Series A Convertible Preferred Stock
2. Conversion or Exercise Price of Derivative Security:
1. $1.03
2. $1.00
3. Transaction Date (Month/Day/Year):
1. January 20, 2000
2. January 20, 2000
4. Transaction Code (Instr. 8):
Code: A
V:
5. Number of Derivaties Securities Acquired (A) or Disposed of
(D) (Instr. 3, 4, and 5):
1. (A) 50,000 options
2. (A) 400,000 shares
6. Date Exercisable and Expiration Date (Month/Day/Year):
1. Date Exercisable: 12,500 shares exercisable on
January 20, 2001; an additional 12,500 shares
exercisable on January 20, 2002; an additional
12,500 shares exercisable on January 20, 2003; and
an additional 12,500 shares exercisable on January
20, 2004.
Expiration Date: January 19, 2010
2. Date Exercisable: Immediately
Expiration Date: None
7. Title and Amount of Underlying Securities (Instr. 3 and
4):
1. Title: Common Stock
Amount or Number of Shares: 50,000
2. Title: Series A Convertible Preferred Stock
Amount or Number of Shares: 400,000
8. Price of Derivative Security (Instr. 5):
1. $ -
2. $400,000
9. Number of Derivative Securities Beneficially Owned at End of
Month (Instr. 4):
1. 50,000
2. 400,000
10. Ownership Form of Derivative Security: Direct (D) or
Indirect (I) (Instr. 4):
1. D
2. I
11. Nature of Indirect Beneficial Ownership (Instr. 4):
As a 25% owner and director of Jacksonville Restaurant
Acquisition Corporation.
Explanation of Responses:
/s/ James W. Osborn
Date: February 4, 2000
