0001193125-11-132321.txt : 20110509 0001193125-11-132321.hdr.sgml : 20110509 20110509160549 ACCESSION NUMBER: 0001193125-11-132321 CONFORMED SUBMISSION TYPE: 15-12G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20110509 DATE AS OF CHANGE: 20110509 EFFECTIVENESS DATE: 20110509 FILER: COMPANY DATA: COMPANY CONFORMED NAME: UCI MEDICAL AFFILIATES INC CENTRAL INDEX KEY: 0000737561 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093] IRS NUMBER: 592225346 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 15-12G SEC ACT: 1934 Act SEC FILE NUMBER: 000-13265 FILM NUMBER: 11823535 BUSINESS ADDRESS: STREET 1: 1901 MAIN ST MAIL CODE 1105 STREET 2: STE 1200 CITY: COLUMBIA STATE: SC ZIP: 29201 BUSINESS PHONE: 8032523661 MAIL ADDRESS: STREET 1: 1901 MAIN ST MAIL CODE 1105 STREET 2: SUITE 1200 CITY: COLUMBIA STATE: SC ZIP: 29201 15-12G 1 d1512g.htm 15-12G 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 0-13265

 

 

UCI MEDICAL AFFILIATES, INC.

(Exact name of registrant as specified in its charter)

1818 Henderson Street, Columbia, South Carolina 29201

(803) 782-4278

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)

Common Stock, $.05 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)    x              

Rule 12g-4(a)(2)

   ¨              

Rule 12h-3(b)(1)(i)

   x              

Rule 12h-3(b)(1)(ii)

   ¨              

Rule 15d-6

   ¨              

Approximate number of holders of record as of the certification or notice date: 2


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.

 

Date: May 9, 2011    

UCI MEDICAL AFFILIATES, INC.

(Registrant)

    By:   /s/ Joseph A. Boyle
       

Name:  Joseph A. Boyle, CPA

Title:    Chief Financial Officer