0001140361-18-029766.txt : 20180625 0001140361-18-029766.hdr.sgml : 20180625 20180625160245 ACCESSION NUMBER: 0001140361-18-029766 CONFORMED SUBMISSION TYPE: 15-12B PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20180625 DATE AS OF CHANGE: 20180625 EFFECTIVENESS DATE: 20180625 FILER: COMPANY DATA: COMPANY CONFORMED NAME: BLACKHAWK NETWORK HOLDINGS, INC CENTRAL INDEX KEY: 0001411488 STANDARD INDUSTRIAL CLASSIFICATION: FINANCE SERVICES [6199] IRS NUMBER: 432099257 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 15-12B SEC ACT: 1934 Act SEC FILE NUMBER: 001-35882 FILM NUMBER: 18917089 BUSINESS ADDRESS: STREET 1: 6220 STONERIDGE MALL ROAD CITY: PLEASANTON STATE: CA ZIP: 94588 BUSINESS PHONE: 925-226-9990 MAIL ADDRESS: STREET 1: 6220 STONERIDGE MALL ROAD CITY: PLEASANTON STATE: CA ZIP: 94588 FORMER COMPANY: FORMER CONFORMED NAME: BLACKHAWK NETWORK HOLDINGS INC DATE OF NAME CHANGE: 20070904 15-12B 1 form1512b.htm 15-12B
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          
001-35882

Blackhawk Network Holdings, Inc.
(Exact name of registrant as specified in its charter)

6220 Stoneridge Mall Road
Pleasanton, CA 94588
(925) 226-9990
(Address, including zip code, and telephone number, including area code, of registrant's principal executive offices)

Common Stock, par value $0.001 per share
(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)
T
Rule 12g-4(a)(2)
☐
Rule 12h-3(b)(1)(i)
T
Rule 12h-3(b)(1)(ii)
☐
Rule 15d-6
☐

Approximate number of holders of record as of the certification or notice date:   
One (1)*

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

     
Blackhawk Network Holdings, Inc.
       
Date:
June 25, 2018
  
By:
/s/ Kirsten E. Richesson
       
Name: Kirsten E. Richesson
       
Title: General Counsel and Secretary

 
* On June 15, 2018, pursuant to an Agreement and Plan of Merger, dated as of January 15, 2018, by and among Blackhawk Network Holdings, Inc. (the “Company”), BHN Holdings, Inc. (“Parent”) and BHN Merger Sub, Inc. (“Merger Sub”), Merger Sub merged with and into the Company (the “Merger”), with the Company surviving the Merger as the surviving corporation and as a wholly owned subsidiary of Parent.