-----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, LKg1m6yFuFMcOHeYaNq0+tT+UgoJQ+er+KCqQ0WYyI3YiX/3DftO21qrEqQtucPe I+7wcszq7gfY3XLEb1Ke1g== 0000950123-10-099333.txt : 20101102 0000950123-10-099333.hdr.sgml : 20101102 20101102134905 ACCESSION NUMBER: 0000950123-10-099333 CONFORMED SUBMISSION TYPE: 15-12G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20101102 DATE AS OF CHANGE: 20101102 EFFECTIVENESS DATE: 20101102 FILER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN PHYSICIANS CAPITAL INC CENTRAL INDEX KEY: 0001118148 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 383543910 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 15-12G SEC ACT: 1934 Act SEC FILE NUMBER: 000-32057 FILM NUMBER: 101157495 BUSINESS ADDRESS: STREET 1: 1301 NORTH HAGADORN ROAD CITY: EAST LANSING STATE: MI ZIP: 48823 BUSINESS PHONE: 5173511150 MAIL ADDRESS: STREET 1: 1301 NORTH HAGADORN ROAD CITY: EAST LANSING STATE: MI ZIP: 48823 15-12G 1 k49761e15v12g.htm 15-12G e15v12g
 
 
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: 000-32057
AMERICAN PHYSICIANS CAPITAL, INC.
(Exact name of registrant as specified in its charter)
1301 North Hagadorn Road
East Lansing, Michigan 48823
(517) 351-1150
(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)
Common stock, no par value
(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)
  þ
 
    
Rule 12g-4(a)(2)
  o
 
    
Rule 12h-3(b)(1)(i)
  þ
 
    
Rule 12h-3(b)(1)(ii)
  o
 
    
Rule 15d-6
  o
 
 

 

 

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, American Physicians Capital, Inc., has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.
         
  AMERICAN PHYSICIANS CAPITAL, INC.
 		  
Date: November 2, 2010  By:   /s/ Richard E. Anderson, M.D.    
    Name:   Richard E. Anderson, M.D.   
    Title:   President and Chief Executive Officer   
 
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.

 

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