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FORM 3
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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
Robenalt John F. Statement Trading Symbol of Original
- ---------------------------------------- (Month/Day/Year) JUST LIKE HOME, INC.;"JLHC" (Month/Day/Year)
(Last) (First) (Middle) 4/10/97 ----------------------------------
7440 Tamiami Trail North ---------------------------- 5. Relationship of Reporting -----------------------
- ---------------------------------------- 3. IRS or Social Security Person to Issuer 7. Individual or Joint/
(Street) Number of Reporting (Check all applicable) Group Filing (Check
Nokomis Florida 32475 Person (Voluntary) X Director X 10% Owner applicable line)
- -------------------------------------- ----- ----- X Form filed by
(City) (State) (Zip) ---------------------------- X Officer Other ----- One Reporting
----- (give ----- (specify Person
title below) below) Form filed by
PRESIDENT, CEO, COO ----- 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 80,000 SHARES D
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COMMON STOCK 22,500 SHARES I BY SELF AS TRUSTEE FOR
MINOR CHILDREN
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COMMON STOCK 297,500 SHAES I BY SPOUSE*
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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
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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:
* Reporting person disclaims beneficial ownership of these shares for purposes of Section 16.
/s/ John F. Robenalt April 30, 1997
**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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