-----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, EosiQM51D5ucsehNAwFBk7Xb80aGBkLp+8s/DdXEQkdDNrNWyah5fOldcNzv8Fx7 CIw++XrmPw2ObpDBWbFUVg== 0000922423-00-500048.txt : 20001204 0000922423-00-500048.hdr.sgml : 20001204 ACCESSION NUMBER: 0000922423-00-500048 CONFORMED SUBMISSION TYPE: 15-12B PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20001114 FILER: COMPANY DATA: COMPANY CONFORMED NAME: MALLINCKRODT INC /MO CENTRAL INDEX KEY: 0000051396 STANDARD INDUSTRIAL CLASSIFICATION: 2835 IRS NUMBER: 361263901 STATE OF INCORPORATION: NY FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 15-12B SEC ACT: SEC FILE NUMBER: 001-00483 FILM NUMBER: 767202 BUSINESS ADDRESS: STREET 1: 675 MCDONNELL BLVD STREET 2: PO BOX 5840 CITY: ST LOUIS STATE: MO ZIP: 63134 BUSINESS PHONE: 3146542000 MAIL ADDRESS: STREET 1: 675 MCDONNELL BLVD CITY: ST LOUIS STATE: MO ZIP: 63134 FORMER COMPANY: FORMER CONFORMED NAME: MALLINCKRODT INC /MO DATE OF NAME CHANGE: 19970625 FORMER COMPANY: FORMER CONFORMED NAME: MALLINCKRODT GROUP INC DATE OF NAME CHANGE: 19940322 FORMER COMPANY: FORMER CONFORMED NAME: IMCERA GROUP INC DATE OF NAME CHANGE: 19920703 15-12G 1 0001.txt 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 Exchange Act of 1934 Commission File Number 1-483 Mallinckrodt Inc. ------------------------------------------------------------------ (Exact name of registrant as specified in its charter) 675 McDonnell Boulevard, St. Louis, Missouri 63134 ------------------------------------------------------------ (Address, including zip code, and telephone number, including area code, of registrant's principal executive offices) Common Stock, $1.00 par value per share 4% Cumulative Preferred Stock, par value $100 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)(i) [ ] 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 [ ] Rule 12h-3(b)(1)(i) [X ] Approximate number of holders of record as of the certification or notice date: Description of Security Number of Holders - - ----------------------- ----------------- Common Stock, par value $1.00 per share 1 4% Cumulative Preferred Stock, par value $100 per share 126 Pursuant to the requirements of the Securities Exchange Act of 1934, Mallinckrodt Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person. DATE: November 14, 2000 MALLINCKRODT INC. By: /s/ C. Ray Holman ------------------------- Name: C. Ray Holman Title: Chief Executive Officer -2- -----END PRIVACY-ENHANCED MESSAGE-----