-----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, Ac9ijY/oFj+Vp/uBSOc1RQICZrc6dcl8TaBMJSPZ6fLQPi5dOOXUzyTOPSSE+ATk 6yDyzULbgEKOSvll9PVs2g== 0000950172-04-000846.txt : 20040406 0000950172-04-000846.hdr.sgml : 20040406 20040406104936 ACCESSION NUMBER: 0000950172-04-000846 CONFORMED SUBMISSION TYPE: 15-12G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040406 EFFECTIVENESS DATE: 20040406 FILER: COMPANY DATA: COMPANY CONFORMED NAME: THERASENSE INC CENTRAL INDEX KEY: 0001073695 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 943267373 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 15-12G SEC ACT: 1934 Act SEC FILE NUMBER: 000-33139 FILM NUMBER: 04719424 BUSINESS ADDRESS: STREET 1: 1360 S LOOP RD STREET 2: SUITE 2000 CITY: ALAMEDA STATE: CA ZIP: 94502 BUSINESS PHONE: 5107495400 MAIL ADDRESS: STREET 1: 1360 S LOOP RD CITY: ALAMEDA STATE: CA ZIP: 94502 15-12G 1 chi447978.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: 000-33139 TheraSense, Inc. ------------------------------------------------------ (Exact name of registrant as specified in its charter) 1360 South Loop Road, Alameda, California 94502 (510) 749-5400 ------------------------------------------------------------------- (Address, including zip code, and telephone number, including area code, of registrant's principal executive offices) Common Stock, par value $0.001 per share Preferred Stock Purchase Rights ------------------------------------------------------- (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 provisions(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 12g-4(a)(2)(ii) |_| Rule 12h-3(b)(2)(ii) |_| Rule 15d-6 |_| 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, TheraSense, Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person. Date: April 6, 2004 THERASENSE, INC. BY: /s/ Edward J. Fiorentino ---------------------------- Name: Edward J. Fiorentino Title: President 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. -----END PRIVACY-ENHANCED MESSAGE-----