SEC-2069 Form 15

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

(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)

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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:
SEC 2069 (08-11)

By:
Potential persons who are to respond to the collection of information contained in
this Form are not required to respond unless the Form displays a currently valid
OMB control number.

Instruction: This form is required by Rules 12g-4, 12h-3, 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.

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