15-12G 1 f15-12g_051104.txt FORM 15 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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 001-13125 ---------------------- Extended Stay America, Inc. -------------------------------------------------------------------------------- (Exact name of registrant as specified in its charter) 100 Dunbar Street, Spartanburg, SC 29306 (864) 573-1600 -------------------------------------------------------------------------------- (Address, including zip code, and telephone number, including area code, of registrant's principal executive offices) Common Stock , $.01 par value 9.15% Senior Subordinated Notes due 2008 9 7/8% Senior Subordinated Notes due 2011 -------------------------------------------------------------------------------- (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)(i) |X| Rule 12h-3(b)(1)(i) |X| Rule 12g-4(a)(1)(ii) |_| Rule 12h-3(b)(1)(ii) |_| Rule 12g-4(a)(2)(i) |_| Rule 12h-3(b)(2)(i) |_| Rule l2g-4(a)(2)(ii) |_| Rule 12h-3(b)(2)(ii) |_| Rule 15d-6 |_| Common Stock: 1 2008 Notes: 21 Approximate number of holders of record as of the 2011 Notes: 7 certification or notice date: ----------------------- Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person. Date: May 11, 2004 By: /s/James A. Ovenden --------------------- James A. Ovenden Chief Financial Officer