Sec Form 15 - Certification And Notice Of Termination Of Registration printable pdf download

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UNITED STATES

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SECURITIES AND EXCHANGE COMMISSION

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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 _________________________ __

__________________________________________________________________________________________________

(Exact name of registrant as specified in its charter)

__________________________________________________________________________________________________

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)

__________________________________________________________________________________________________

(Title of each class of securities covered by this Form)

__________________________________________________________________________________________________

(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)

Rule 12g-4(a)(2)

Rule 12h-3(b)(1)(i)

Rule 12h-3(b)(1)(ii)

Rule 15d-6

Rule 15d-22(b)

Approximate number of holders of record as of the certification or notice date: _______________________________

Pursuant to the requirements of the Securities Exchange Act of 1934 (Name of registrant as specified in charter) has

caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.

Date: _______________________________ By: ___________________________________________________________

Instruction: This form is required by Rules 12g-4, 12h-3 and 15d-6 and 15d-22 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.

Persons who respond to the collection of information contained in this form are

not required to respond unless the form displays a currently valid OMB control

SEC 2069 (08-11)

number.

Sec Form 15 - Certification And Notice Of Termination Of Registration