-----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, CTuoFiklb3RnzRdhxCNSvxOKSBLs4+Jki7m6CiG63X5n8Qi0gOpGi/Y6iVFsjqFh MAEKM8ap0G0n6IF+izzduw== 0000912057-97-006450.txt : 19970223 0000912057-97-006450.hdr.sgml : 19970223 ACCESSION NUMBER: 0000912057-97-006450 CONFORMED SUBMISSION TYPE: 15-12G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970221 SROS: NASD FILER: COMPANY DATA: COMPANY CONFORMED NAME: PACIFICARE HEALTH SYSTEMS INC CENTRAL INDEX KEY: 0000766456 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 330064895 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 15-12G SEC ACT: 1934 Act SEC FILE NUMBER: 000-14181 FILM NUMBER: 97540998 BUSINESS ADDRESS: STREET 1: 5995 PLAZA DR CITY: CYPRESS STATE: CA ZIP: 90630 BUSINESS PHONE: 7149521121 MAIL ADDRESS: STREET 1: 5995 PLAZA DRIVE CITY: CYPRESS STATE: CA ZIP: 90630 15-12G 1 FORM 15-12G 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 PacifiCare Operations, Inc. (formerly named PacifiCare Health Systems, Inc.) --------------------------------------------------------------------------- (Exact name of registrant as specified in its charter) Delaware 0-14181 33-0064895 --------------- ----------- --------------------- (State or other (Commission (I.R.S. Employer jurisdiction of File Number) Identification Number) incorporation) 5995 Plaza Drive, Cypress, CA 90630 ----------------------------------------------- (Address of principal executive offices) (714) 952-1121 ----------------------------------------------- (Registrant's telephone number, including area code) Class A Common Stock, par value $0.01 per share ("Class A Common") Class B Common Stock, par value $0.01 per share ("Class B Common") ------------------------------------------------------------------- (Title of each class of securities covered by this form) N/A ---------------------------------------------------- (Titles of all other classes of securities for which a duty to file reports under Section 13(a) or 15(d) remains) 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: /x/ Rule 12g-4(a)(1)(i) / / Rule 12g-4(a)(2)(ii) / / Rule 12h-3(b)(2)(i) / / Rule 12g-4(a)(1)(ii) / / Rule 12h-3(b)(1)(i) / / Rule 12h-3(b)(2)(ii) / / Rule 12g-4(a)(2)(i) / / Rule 12h-3(b)(1)(ii) / / Rule 15d-6 Approximate number of holders of record as of the certification or notice date: Class A Common: 1 Class B Common: 0 Pursuant to the requirements of the Securities Exchange Act of 1934, PacifiCare Operations, Inc. has duly caused this Certification/Notice to be signed on its behalf by the undersigned duly authorized person. PACIFICARE OPERATIONS, INC. February 21, 1997 By: /s/ Joseph Konowiecki ------------------------------- JOSEPH KONOWIECKI GENERAL COUNSEL -----END PRIVACY-ENHANCED MESSAGE-----