-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KYZ03hoFBMv6OdzrPZPpJltk84mrk/bliS8jk1dYt4rO9FTU+I4ggADFm8mwFo0u uiNmmtdXZlLSLq62ToaMbw== 0001221508-04-000014.txt : 20040330 0001221508-04-000014.hdr.sgml : 20040330 20040330172256 ACCESSION NUMBER: 0001221508-04-000014 CONFORMED SUBMISSION TYPE: NT 10-K PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040330 EFFECTIVENESS DATE: 20040330 FILER: COMPANY DATA: COMPANY CONFORMED NAME: MEDINA COFFEE INC CENTRAL INDEX KEY: 0001117171 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING & DRINKING PLACES [5810] IRS NUMBER: 880442833 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: NT 10-K SEC ACT: 1934 Act SEC FILE NUMBER: 000-49712 FILM NUMBER: 04702649 BUSINESS ADDRESS: STREET 1: P O BOX 741 CITY: BELLEVUE STATE: WA ZIP: 98009 BUSINESS PHONE: 4254530334 MAIL ADDRESS: STREET 1: P O BOX 741 CITY: BELLEVUE STATE: WA ZIP: 98009 NT 10-K 1 late_qfiling.htm NOTICE OF LATE FILING OF 10-KSB Notice of Late Filing of 10-KSB
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION|
WASHINGTON, D.C. 20549
 

FORM 12b-25

NOTIFICATION OF LATE FILING
 

(Check One):     [ X ] Form 10-K [ ] Form 20-F [ ] Form 11-K [  ] Form 10-Q [ ] Form N-SAR

 

For Period Ended: December 31, 2003

SEC FILE NUMBER:    000-49712  

 

CUSIP NUMBER :   584709 10 9 

   
[ ] Transition Report on Form 10-K  
[ ] Transition Report on Form 20-F  
[ ] Transition Report on Form 11-K  
[ ] Transition Report on Form 10-Q  
[ ] Transition Report on Form N-SAR  

For the Period Ended:

 
   
Nothing in this form shall be construed to imply that the Commission has verified any information contained herein.
   

If the notification relates to a portion of the filing checked above, identify the Item(s) to which the notification relates:                                                                                Entire Form 10-QSB

   
PART I - REGISTRANT INFORMATION
   
Full Name of Registrant: MEDINA COFFEE, INC.
   
Former Name if Applicable: N/A
   
Address of Principal Executive Office: P.O. Box 741
  Bellevue, WA 98009
PART II--RULES 12b-25 (b) AND (c)
   
If the subject report could not be filed without unreasonable effort or expense and the registrant seeks relief pursuant to Rule 12b-25(b) the following should be completed. (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, semi-annual report, transition report on Form 10-K, Form 2-F, 11-F, or From N-SAR, or portion thereof will be filed on or before the fifteenth calendar day following the prescribed due date; or the subject quarterly report or transition report on Form 10-Q, or portion thereof will be filed on or before the fifth calendar day following the prescribed due date; and
     

[  ]

(c)

The accountant's statement or other exhibit required by Rule 12b-25(c) has been attached if applicable.
     
PART III - NARRATIVE
     
State below in reasonable detail the reasons why form 10-K, 11-K, 20-F, 10-Q or N-SAR or portion thereof could not be filed within the prescribed time period.
     

The registrant was unable without unreasonable effort and expense to prepare its accounting records and schedules in sufficient time to allow its accountants to complete its review of the registrant for its fiscal year ended December 31, 2003, before the required filing date for its Form 10-KSB.

     
PART IV- OTHER INFORMATION
     
  (1) Name and telephone number of person to contact in regard to this notification.
         
   

Harry Miller

President & CEO

(425) 453-0355

   

(Name)

(Title)

(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 12 months or for such shorter period that the registrant was required to file such report(s) been filed? If the answer if 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?
   

[  ] Yes

[X] No

 
         
  If so, attach an explanation of the anticipated change, both narrative and quantitatively, and, if appropriate, state the reasons why a reasonable estimate of the results cannot be made - Corporate offices and management changes.
   

N/A

   
   

MEDINA COFFEE, INC.
(Name of Registrant as specified in Charter)

   

has caused this notification to be signed on its behalf by the undersigned thereunto duly authorized.

   
Date: March 30, 2004 By:   /s/ Harry Miller
  Name: Harry Miller
  Title: President & CEO

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