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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: 333-05358C
MAMA TISH'S ITALIAN SPECIALTIES, INC.
(Exact name of registrant as specified in its charter)
4800 SOUTH CENTRAL AVENUE
CHICAGO, ILLINOIS 60638
(708) 929-2023
(Address, including zip code, and telephone number, including area code, of
registrant's principal executive offices)
UNITS
COMMON STOCK, PAR VALUE $.01 PER SHARE
REDEEMABLE COMMON STOCK WARRANTS
UNDERWRITER'S PURCHASE OPTION
UNITS UNDERLYING THE UNDERWRITER'S PURCHASE OPTION
WARRANTS INCLUDED IN THE UNITS UNDERLYING THE UNDERWRITER'S PURCHASE OPTION
(Title of each class of securities covered by this Form)
NONE
(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)(ii) [ ]
Rule 12g-4(a)(1)(ii) [ ] Rule 12h-3(b)(2)(i) [ ]
Rule 12g-4(a)(2)(i) [ ] Rule 12h-3(b)(2)(ii) [ ]
Rule 12g-4(a)(2)(ii) [ ] Rule 15d-6 [ ]
Rule 12h-3(b)(1)(i) [ ]
Approximate number of holders of record as of the certification or
notice date:
Units: 20
Common Stock, par value, $.01 per share: 32
Redeemable Common Stock Warrants: 20
Underwriter's Purchase Option: None
Units underlying the Underwriter's Purchase Option: None
Warrants included in the Units Underlying the Underwriter's Purchase
Option: None
Pursuant to the requirements of the Securities Exchange Act of 1934,
the Registrant has caused this certification/notice to be signed on its behalf
by the undersigned duly authorized person.
MAMA TISH'S ITALIAN SPECIALTIES, INC.
By: /s/ MEADE H. RUDASILL
-------------------------------------
Meade H. Rudasill
President and Chief Executive Officer
DATE: November 27, 1996
