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FORM 3 OMB APPROVAL
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OMB Number:
Expires:
Estimated average burden
hours per response ......
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U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 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(f)
of the Investment Company Act of 1940
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<S> <C> <C> <C>
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1. Name and Address of Reporting Person* 2. Date of Event Requiring 4. Issuer Name and Ticker or 6. If Amendment, Date
Green Thomas Statement Trading Symbol of Original
- ---------------------------------------- (Month/Day/Year) California Culinary Academy, Inc. (Month/Day/Year)
(Last) (First) (Middle) 9/30/98 (COOK)
601 South Figueroa Street ---------------------------- ---------------------------------- -----------------------
- ---------------------------------------- 3. IRS or Social Security 5. Relationship of Reporting 7. Individual or Joint/
(Street) Number of Reporting Person to Issuer Group Filing (Check
Los Angeles CA 90017 Person (Voluntary) (Check all applicable) applicable line)
- -------------------------------------- Director X 10% Owner X Form filed by
(City) (State) (Zip) ---------------------------- ----- ----- ----- One Reporting
Officer Other Person
----- (give ----- (specify Form filed by
title below) below) ----- More than One
---------------------------------- Reporting Person
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TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect
(Instr. 4) Beneficially Owned Direct (D) or Beneficial
(Instr. 4) Indirect (I) Ownership (Instr. 4)
(Instr. 5)
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Common Stock(1) 404,869 D
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*If the form is filed by more than one Reporting Person, see Instruction 5(b)(v).
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
(Print or Type Responses) (8/96)
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FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C>
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1. Title of Derivative Security 2. Date 3. Title and Amount of 4. Conver- 5. Owner- 6. Nature of Indirect
(Instr. 4) Exercisable and Securities Underlying sion or ship Beneficial Ownership
Expiration Date Derivative Security Exercise Form of (Instr. 5)
(Month/Day/ (Instr. 4) Price of Deriv-
Year) Deri- ative
vative Security:
Security
------------------------------------------------- Direct
Date Expira- Amount or (D) or
Exercis- tion Title Number Indirect (I)
able Date of Shares (Instr. 5)
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Explanation of Responses:
/s/ Thomas Green
**Intentional misstatements or omissions of facts constitute Federal Criminal ------------------------------- ------------------
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). **Signature of Reporting Person Date
Note. File three copies of this form, one of which must be manually signed. Page 2
If space provided is insufficient, See Instruction 6 for procedure. (8/96)
(Print or Type Responses)
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(1) Includes 292,407 shares held in a trading account of Thomas Green
Securities, Inc., a broker-dealer of which Thomas C. Green is the
sole shareholder.