-----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, TDCD794tL1e8nW/Ge/j8ZCj0xUYTqgXoYScvPXjWG0hNg8dGdrHQ2ooAZ5PSC3NC eadjF1Ebs9ZQXAXiK26YwA== 0000898822-99-000641.txt : 19991117 0000898822-99-000641.hdr.sgml : 19991117 ACCESSION NUMBER: 0000898822-99-000641 CONFORMED SUBMISSION TYPE: 15-12G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19991115 FILER: COMPANY DATA: COMPANY CONFORMED NAME: MAXXIM MEDICAL INC CENTRAL INDEX KEY: 0000858660 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 760291634 STATE OF INCORPORATION: TX FISCAL YEAR END: 1031 FILING VALUES: FORM TYPE: 15-12G SEC ACT: SEC FILE NUMBER: 000-18208 FILM NUMBER: 99755466 BUSINESS ADDRESS: STREET 1: 10300 49TH ST N CITY: CLEARWATER STATE: FL ZIP: 33762 BUSINESS PHONE: 7275612100 MAIL ADDRESS: STREET 1: 10300 49TH STREET NORTH CITY: CLEARWATER STATE: FL ZIP: 33762 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 Commission File Number: 001-10600 MAXXIM MEDICAL, INC. (Exact name of registrant as specified in its charter) 10300 49th Street North Clearwater, Florida 33762 (727) 561-2100 (Address, including zip code and telephone number, including area code, of registrant's principal executive offices) Common Stock, par value $.001 per share (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) [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 15d-6 [ ] Rule 12h-3(b)(1)(i) [X] Approximate number of holders of record as of the certification or notice date: 19 Pursuant to the requirements of the Securities Exchange Act of 1934, Maxxim Medical, Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person. MAXXIM MEDICAL, INC., a Texas corporation DATE: November 12, 1999 By: /s/ Alan S. Blazei ---------------------------------------- Name: Alan S. Blazei Title: Executive Vice President and Controller -----END PRIVACY-ENHANCED MESSAGE-----