-----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, HQmGhugnqBAxE26HFiDDMRveTpltASZDaNwxw8j/Kx+FrGklWnEt+0wOE3Nixktr 3qC0IynBoJ6T4w5v9FyryQ== 0001194794-10-000068.txt : 20101201 0001194794-10-000068.hdr.sgml : 20101201 20101201122129 ACCESSION NUMBER: 0001194794-10-000068 CONFORMED SUBMISSION TYPE: 15-12G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20101201 DATE AS OF CHANGE: 20101201 EFFECTIVENESS DATE: 20101201 FILER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN PHYSICIANS SERVICE GROUP INC CENTRAL INDEX KEY: 0000724024 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 751458323 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 15-12G SEC ACT: 1934 Act SEC FILE NUMBER: 000-11453 FILM NUMBER: 101224095 BUSINESS ADDRESS: STREET 1: 1301 CAPITAL OF TEXAS HWY STREET 2: C-300 CITY: AUSTIN STATE: TX ZIP: 78746 BUSINESS PHONE: 5123280888 MAIL ADDRESS: STREET 1: 1301 CAPITAL OF TEXAS HIGHWAY CITY: AUSTIN STATE: TX ZIP: 78746 15-12G 1 bodyoffiling.htm FORM 15-12G FILED DECEMBER 1, 2010 bodyoffiling.htm

 
SECURITIES AND EXCHANGE COMMISSION
 
Washington D.C. 20549
 

 
FORM 15
 

 
CERTIFICATE 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 001-31434                                                                           
 
American Physicians Service Group, Inc.
(Exact name of registrant as specified in its charter)
1301 S. Capital of Texas Highway, Suite C-300
Austin, Texas 78746
(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)
 
Common Stock, $0.001 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 and X in the box(es) to designate the appropriate rules provision(s) relied upon to terminate or suspend the duty to file reports:
Rule 12g-4(a)(1)
   x
Rule 12g-4(a)(2)
   o
Rule 12h-3(b)(1)(i)
   o
Rule 12h-3(b)(1)(ii)
   o
Rule 15d-6
   o
 
Approximate number of holders of record as of the certification or notice date:
                Common Stock – 1
 
Pursuant to the requirements of the Securities Exchange Act of 1934, the Issuer has caused this certification/notice to be signed on their behalf by the undersigned duly authorized person.
 
Date: December 1, 2010
                                                                                      By: /s/ Victor T. Adamo                                                       
                   Victor T. Adamo, President
 
 
Persons who respond to the collection of information contained in this form are not required unless the form displays a currently valid OMB control number.
SEC 2069(02-08)
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