SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 12b-25 NOTIFICATION OF LATE FILING
[X] Form 11-K
For the Period Ended November 30, 1995
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Nothing in this form shall be construed to imply that the Commission has
verified any information contained herin.
If the notification relates to a portion of the filing checked above, identify
the item(s) to which the notification relates.
PART I - REGISTRANT INFORMATION
TOKHEIM CORPORATION
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(Exact name of registrant as specified in its charter)
RETIREMENT SAVINGS PLAN FOR EMPLOYEES OF
TOKHEIM CORPORATION AND SUBSIDIARIES
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(Full title of the plan)
Indiana 1-6018 35-0712500
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(State of Incorporation) (Commission File Number) (I.R.S. Employer I.D. No.)
10501 Corporate Drive, P.O. Box 360, Fort Wayne, Indiana 46801
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(Address of principal executive offices) (Zip Code)
Registrant's telephone number, including area code: (219) 470-4600
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PART II - RULES 12b-25(B) AND (C)
The subject report could not be filed without unreasonable effort or expense
and the registrant seeks relief pursuant to Rule 12b-25(b):
(Check box if appropriate)
[X] (a) The reasons described in reasonable detail in Part III of this form
could not be eliminated without unreasonable effort or expense;
[X] (b) The subject annual report, on Form 11-K will be filed on or before
the fifteenth calendar day following the prescribed due date; and
[ ] (c) The accountant's statement by the Rule 12b-25 has been attached.
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PART III - NARRATIVE
Stated below, in reasonable detail, are the reasons why Form 11-K or the
transition report or portion thereof could not be filed within the prescribed
time period:
The Company was not able to file Form 11-K within the prescribed time period
due to being unable to accurately reconcile certain amounts included in the
statement of net assets available for plan benefits, statement of changes in
net assets available for plan benefits, and the detailed schedule presented by
fund for such statements to the respective amounts included in the trust
statements provided by the Trustee. As a result of this, the independent
accountants do not have the necessary information to complete their audit and
to furnish their audit report by the due date prescribed in Form 11-K.
See attached Statement of Independent Accountants.
PART IV - OTHER INFORMATION
(1) Name and telephone number of person to contact in regard to this
notification.
John A. Negovetich 219 470-4677
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(Name) (Area Code) (Telephone Number)
(2) Have all other periodic reports required under Section 13 or 15(d) of the
Securities Exchange Act of 1934 or Section 30 of the Investment Company Act
of 1940 during the preceding 12 months or for such shorter period that the
registrant was required to file such report(s) been filed? If answer is no,
identify report(s).
[ X ] YES [ ] NO
(3) Is it anticipated that any significant change in results of operations from
the corresponding period for the last fiscal year will be reflected by the
earnings statements to be included in the subject report or portion thereof?
If yes, provide explanation of the anticipated change and state the reasons
why a reasonable estimate of the results cannot be made.
[ X ] YES [ ] NO
A significant change in the statement of changes in net assets available for
plan benefits from the corresponding period ended November 30, 1994 will be
reflected in net additions to assets available for plan benefits for the year
ended November 30, 1995, due primarily to an increase in employer
contributions of $737,000, an increase in net appreciation in the fair value
of investments of $1,386,000 and a decrease in withdrawal and termination
distributions of $535,000.
TOKHEIM CORPORATION
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(Name of Registrant as specified in Charter)
has caused this notification to be signed on its behalf by the undersigned
thereunto duly authorized.
Date: May 29, 1996 By: JOHN A. NEGOVETICH
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Vice President and Chief
Financial Officer
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STATEMENT OF INDEPENDENT ACCOUNTANTS
The firm of Coopers & Lybrand L.L.P. is the independent auditor of Tokheim
Corporation and its Retirement Savings Plan for Employees of Tokheim
Corporation and Subsidiaries.
We are writing with respect to Tokheim Corporation's Form 12b-25 filing for
Notification of Late Filing Form 11-K Annual Report due May 28, 1996, and have
prepared this letter as an attachment thereto.
The Company has been unable to complete Financial Statements for its Retirement
Savings Plan for Employees of Tokheim Corporation and Subsidiaries and
accordingly we have been unable to complete our audit of such statements.
COOPERS & LYBRAND L.L.P.
May 29, 1996
