15-12G 1 d1512g.htm FORM 15 Form 15

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 and Exchange Act of 1934

 

Commission File Number 000-31173

 


 

ChipPAC, Inc.

(Exact name of registrant as specified in its charter)

 


 

47400 Kato Road

Fremont, California 94538

(510) 979-8000

(Address, including zip code, and telephone number, including area code,

of Registrant’s principal executive offices)

 

Class A Common Stock, par value $0.01 per share

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

 

None

(Title 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)    ¨

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: One

 

Pursuant to the requirements of the Securities Exchange Act of 1934, ChipPAC, Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.

 

Dated: August 4, 2004

  By:   

/s/ Tan Lay Koon


   

Name:

  

Tan Lay Koon

   

Title:

  

Chairman of the Board and President