SECURITIES AND EXCHANGE COMMISSION
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WASHINGTON, DC 20549
FORM 12B-25
Commission File Number 018222
NOTIFICATION OF LATE FILING
(Check one): [x] Form 10-k [ ] Form 11-K [ ] Form 20-k [ ] Form 10-Q
[ ] Form N-SAR
For Period Ended: September 30, 1997
[ ] Transition Report on Form 10-k [ ] Transition Report on Form 10-Q
[ ] Transition Report on Form 20-F [ ] Transition Report on Form N-SAR
[ ] Transition Report on Form 11-K
For the Transition Period Ended:
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Read attached instruction sheet before preparing form. Please print or type.
Nothing in this form shall be construed to imply that the Commission has
verified any information contained herein.
If the notification relates to a portion of the filing checked above, idenrify
the item(s) to which the notification relates:
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PART I
REGISTRANT INFORMATION
Full name of registrant: Costa Rica International, Inc.
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Former name if applicable:
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Address of principal executive office (Street and number)
2525 S.W., Third Avenue, Suite 303
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City, State and zip code: Miami, Florida, 33129
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PART II
RULE 12b-25 (b) AND (c)
If the subject report could not be filed without unreasonable effort or
expense and the registrant seeks relief pursuant to Rule 12b-25(b), the
following should be completed. (Check appropiate box)
[x] (a) The reasons described in reasonable detail in Part III of this form
could not be eliminated without unreasonable effort or expense;
[x] (b) The subject annual report, semi-annual report, transition report form
on Form 10-K,20-F11-K or Form N-SAR, or portion thereof will be filed
on or before the 15th calendar day following the prescribed due date;
or the subject quarterly report or transition report on Form 10-Q, or
portion thereof will be filed on or before the fifth calendar day
following the prescribed due date; and
[ ] (c) The accountant's statement or other exhibit required by rule 12b-25
(c) has been attached if applicable.
PART III
NARRATIVE
State below in reasonable detail the reasons why Form 10-K, 11-K, 20-F, 10-Q,
N-SAR or the transition report portion thereof could not be within the
prescribed time period. (Attach extra sheets if needed).
The sole proprietor of the Company retained to Edgarize Form 10-K and the
Accountant's Statement suffered a serious automobile accident on December 28,
1997, and thus has not been able to produce a report to be filed on time.
PART IV
OTHER INFORMATION
(1) Name and telephone number of person to contact in regard to this
notification.
Elena Gonzalez 011-506-239-1084
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(Name) (Area code)(Telephone number)
(2) Have all other periodic reports required under Section 13 or 15(d) of
the Securities Exchange Act of 1934 or Section 30 of the Investment
company Act of 1940 during the preceding 12 months or for such shorter
period that the registrant was required to file such reports(s) been
filed? If the answer is no, identify report(s). YES
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(3) Is it anticipated that any significant change in results of operations
from the corresponding period for the last fiscal year will be reflected
by the earnings statementes to be included in the subject report or
portion thereof? NO
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If so: attach an explanation of the anticipated change, both narratively
and quantitatively, and, if appropriate, state the reasons why a
reasonable estimate of the results cannot be made.
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(Name of Registrant as Specified in Charter)
Has caused this notification to be signed on this behalf by the undersigned
thereunto duly authorized.
Date: By:
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Instruction. The form may be signed by an executive officer of the registrant
or by any other duly authorized representative. The name and title of the
person signing the form shall be typed or printed beneath the signature. If
the statement is signed on behalf of the registrant by an autorized
representative (other than an executive officer), evidence of the
representative's authority to sign on behalf of the registrant shall be filed
with the form.
ATTENTION
Intentional misstatements or omissions of fact constitute Federal criminal
violations (see 18 U.S.C. 1001)
GENERAL INSTRUCTIONS
1) This form is required by Rule 12b-25 of the General Rules and Regulations
under the Securities Exchange Act of 1934.
2) One signed original and four conformed copies of this form and ammendments
thereto must be completed and filed with the Securities and Exchange
Commission, Washington, D.C. 20549, in accordance with Rule 0-3 of the General
Rules and Regulations under the Act. The information contained in or filed
with the form will be made a matter of the public record in the Commission
files.
3) A manually signed copy of the form and amendments thereto shall be filed
with each national securities exchange on which any class of securities of the
registrant is registered.
4) Amendments to the notifications must also be filed on Form 12B-25 but need
not restate information that has been correctly furnished. The form shall be
clearly identified as and amended notification.
5) Electronic Filers.This form shall not be used by electronic filers unable
to timely file a report solely due to electronic difficulties. Filers unable
to subnit a report within the time period prescribed due to difficulties in
electronic filing should comply with either rule 201 or Rule 202 of
Regulation S-T ir apply for adjustment in filing datepursuant to Rule 13(b) of
Regulation S-T.
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DATE: December 30, 1997 (12b25)
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/s/ CALIXTO CHAVES ZAMORA
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CALIXTO CHAVES ZAMORA
Chairman of the Board
Costa Rica International, Inc.
