form1512g07689_03302010.htm
 
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   UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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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 001-13650
 
WESTERN SIZZLIN CORPORATION
(Exact name of registrant as specified in its charter)
 
401 Albemarle Ave SE
Roanoke, Virginia, 24013
(540) 345-3195
(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)
 
Common Stock, par value $0.01 per share
(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)
 x
 
Rule 12g-4(a)(2)
 o
 
Rule 12h-3(b)(1)(i)
 x
 
Rule 12h-3(b)(1)(ii)                                           
 o
 
Rule 15d-6                                
 o

 
Approximate number of holders of record as of the certification or notice date:  1
 
Pursuant to the requirements of the Securities Exchange Act of 1934, Western Sizzlin Corporation has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.
 
Dated:  March 30, 2010
WESTERN SIZZLIN CORPORATION
   
 
By:
 /s/ Robyn B. Mabe
 
Name:
Robyn B. Mabe
 
Title:
Vice President and Chief Financial Officer
 
Instruction: This form is required by Rules 12g-4, 12h-3 and 15d-6 of the General Rules and Regulations under the Securities Exchange Act of 1934.  The registrant shall file with the Commission three copies of Form 15, one of which shall be manually signed. It may be signed by an officer of the registrant, by counsel or by any other duly authorized person. The name and title of the person signing the form shall be typed or printed under the signature.
 
 
SEC2069 (02-08)
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