15-12G 1 americanform1512g.htm NOTICE OF TERMINATION BP -- x1-53856 -- American Hospital -- Form 15-12g

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  0-2751


American Hospital Management Corporation

(Exact name of registrant as specified in its charter)


P.O. Box 1116, Arcata, CA 95518, 707 445 4221

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

of registrant’s principal executive offices)


Common stock, $1.00 par value, Preferred stock, $1.00 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)(i) 

ý

          

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: 292


Pursuant to the requirements of the Securities Exchange Act of 1934 (Name of registrant as specified in charter) has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.


Date:  January 14, 2004

By:

/s/ DOUG SHAW

Doug Shaw