0001116502-01-501291.txt : 20011107
0001116502-01-501291.hdr.sgml : 20011107
ACCESSION NUMBER: 0001116502-01-501291
CONFORMED SUBMISSION TYPE: 15-12G
PUBLIC DOCUMENT COUNT: 1
FILED AS OF DATE: 20011102
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: MEDIQ INC
CENTRAL INDEX KEY: 0000350920
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS EQUIPMENT RENTAL & LEASING [7350]
IRS NUMBER: 510219413
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-12G
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-15500
FILM NUMBER: 1773874
BUSINESS ADDRESS:
STREET 1: ONE MEDIQ PLZ
CITY: PENNSAUKEN
STATE: NJ
ZIP: 08110
BUSINESS PHONE: 6096656300
MAIL ADDRESS:
STREET 1: ONE MEDIQ PLZ
CITY: PENNSAUKEN
STATE: NJ
ZIP: 08110
15-12G
1
mediq-form15.txt
CERTIFICATION AND NOTICE OF TERMINATION
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: 1-8147
MEDIQ, INCORPORATED
-----------------------------------
(Exact name of registrant as specified in its charter)
One MEDIQ Plaza, Pennsauken, New Jersey 08110; (856) 662-3200
-------------------------------------------------------------
(Address, including zip code, and telephone number,
including area code, of registrant's principal executive offices)
Series A 13% Cumulative Compounding Preferred Stock, par value $.01
-------------------------------------------------------------------
(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)(ii) [ ]
Rule 12g-4(a)(1)(ii) [ ] Rule 12h-3(b)(2)(i) [ ]
Rule 12g-4(a)(2)(i) [ ] Rule 12h-3(b)(2)(ii) [ ]
Rule 12g-4(a)(2)(ii) [ ] Rule 15d-6 [X]
Rule 12h-3(b)(1)(i) [ ]
Approximate number of holders of record as of the
certification or notice date: None
SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934,
MEDIQ Incorporated has caused this certification notice to be signed on its
behalf by the undersigned duly authorized person.
MEDIQ Incorporated:
Date: October 29, 2001 By: /s/Regis Farrell
--------------------
Name: Regis Farrell
Title: President