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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-C
REPORT BY ISSUER OF SECURITIES QUOTED ON NASDAQ INTERDEALER
QUOTATION SYSTEM
Filed pursuant to Section 13 or 15(d) of the
Securities Exchange Act of 1934 under rule 13a-17
or 15(d)-17 thereunder
JAVA CENTRALE, INC.
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(Exact name of issuer as specified in charter)
1610 Arden Way, Suite 145
Sacramento, California 95815
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(Address of principal executive offices)
ISSUER'S TELEPHONE NUMBER, INCLUDING AREA CODE: (916) 568-2310
I. CHANGE IN NUMBER OF SHARES OUTSTANDING
1. Title of security: Common Stock, no par value
2. Number of shares outstanding before the change: 13,685,548
3. Number of shares outstanding after the change: 14,389,899
4. Effective date of change: April 29, 1997
Page 1 of 3 Pages
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1. Method of change: Additional shares were issued in five previous
transactions.
(a) On March 18, 1997, 93,644 common shares of stock were issued as a
result of a partial conversion of a convertible noted dated January 29,
1996 with Santina Holding, Inc.;
(b) On March 19, 1997, 54,040 common shares of stock were issued as a
result of a partial conversion of a convertible noted dated December
14, 1995 with Gross Foundation;
(b) On April 10, 1997, 106,667 common shares of stock were issued as a
result of a partial conversion of a convertible noted dated December
14, 1995 with Gross Foundation;
(d) On April 22, 1997, 300,000 common shares of stock were issued as a
result of warrant, being exercised by One Capital Corporation.
(e) On April 29, 1997, 150,000 common shares of stock were issued as a
result of warrant, being exercised by One Capital Corporation
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II. CHANGE IN NAME OF ISSUER
1. Name prior to change: N/A
2. Name after change: N/A
3. Effective date of charter amendment change name: N/A
4. Date of shareholder approval of change, if required: N/A
Date: May 5, 1997
JAVA CENTRALE, INC.
By: /s/
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Steven J. Orlando
Vice President and
Chief Financial Officer
(Officer's signature and title)
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