15-12G 1 FORM 15 1 -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- 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 0-14339 AMGEN BOULDER INC. (EXACT NAME OF REGISTRANT AS SPECIFIED IN ITS CHARTER) (FORMERLY KNOWN AS SYNERGEN, INC.) C/O AMGEN, INC. AMGEN CENTER 1840 DEHAVILLAND DRIVE THOUSAND OAKS, CA 91320-1789 (805) 447-1000 (ADDRESS, INCLUDING ZIP CODE, AND TELEPHONE NUMBER, INCLUDING AREA CODE, OF REGISTRANT'S PRINCIPAL EXECUTIVE OFFICES) COMMON STOCK $.01 PAR VALUE; RIGHTS TO PURCHASE SERIES A JUNIOR PARTICIPATING PREFERRED STOCK (TITLE OF EACH CLASS OF SECURITIES COVERED BY THIS FORM) NONE (TITLE 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 12h-3(b)(1)(i) / / Rule 15d-6 / /
Approximate number of holders of record as of the certification or notice date: 1 HOLDER OF COMMON STOCK, $.01 PAR VALUE; 1 HOLDER OF RIGHTS TO PURCHASE SERIES A JUNIOR PARTICIPATING PREFERRED STOCK Pursuant to the requirements of the Securities Exchange Act of 1934 AMGEN BOULDER INC. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person. DATE: March 28, 1995 BY: /s/ Thomas E. Workman, Jr. ---------------------- ----------------------------------- Vice President, Secretary and General Counsel
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