UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 15
CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER
SECTION 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934 OR
SUSPENSION OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934.
Commission File Number 0-22402
HomeTown Buffet, Inc.
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(Exact name of registrant as specified in its charter)
9171 Towne Centre Drive, Suite 575, San Diego, California 92122
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(Address, including zip code, and telephone number, including
area code, of registrant's principal executive offices)
Common Stock, par value $.01 per share
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(Title of each class of securities covered by this Form)
7% Convertible Subordinated Notes due 2002
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(Titles of all other classes of securities for which a duty
to file reports under section 13(a) or 15(d) remains)
Please place an X in the box(es) to designate the appropriate rule
provision(s) relied upon to terminate or suspend the duty to file reports:
Rule 12g - 4(a)(1)(i) [ X ] Rule 12h - 3(b)(1)(i) [ ]
Rule 12g - 4(a)(1)(ii) [ ] Rule 12h - 3(b)(1)(ii) [ ]
Rule 12g - 4(a)(2)(i) [ ] Rule 12h - 3(b)(2)(i) [ ]
Rule 12g - 4(a)(2)(ii) [ ] Rule 12h - 3(b)(2)(ii) [ ]
Rule 15d - 6 [ ]
Approximate number of holders of record as of the certification or
notice date: One
Pursuant to the requirements of the Securities Exchange Act of 1934
HomeTown Buffet, Inc. has caused this certification/notice to be signed on
its behalf by the undersigned duly authorized person.
Date: September 30, 1996 By: /s/ C. DENNIS SCOTT
Title: Chief Executive Officer
Instruction: This form is required by Rules 12g-4, 12h-3 and 15d-6 of the
General Rules and Regulations under the Securities Exchange Act of 1934.
The registrant shall file with the Commission three copies of Form 15, one
of which shall be manually signed. It may be signed by an officer of the
registrant, by counsel or by any other duly authorized person. The name and
title of the person signing the form shall be typed or printed under the
signature.
