-----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, PxTjhz5XcklHGCZr7TgMyMNZ2QYTEsj4fJM03n5ogcf6eygamV1HvsP4srn0Y7L6 PTRoGndCfK+5VREnXERhJw== 0000950136-04-000013.txt : 20040105 0000950136-04-000013.hdr.sgml : 20040105 20040105165803 ACCESSION NUMBER: 0000950136-04-000013 CONFORMED SUBMISSION TYPE: 15-12B PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040105 EFFECTIVENESS DATE: 20040105 FILER: COMPANY DATA: COMPANY CONFORMED NAME: SIMULA INC CENTRAL INDEX KEY: 0000885080 STANDARD INDUSTRIAL CLASSIFICATION: PUBLIC BUILDING AND RELATED FURNITURE [2531] IRS NUMBER: 860320129 STATE OF INCORPORATION: AZ FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 15-12B SEC ACT: 1934 Act SEC FILE NUMBER: 001-14618 FILM NUMBER: 04505901 BUSINESS ADDRESS: STREET 1: 2700 NORTH CENTRAL AVE STREET 2: STE 1000 CITY: PHOENIX STATE: AZ ZIP: 85004 BUSINESS PHONE: 6026314005 MAIL ADDRESS: STREET 1: 2700 NORTH CENTRAL AVE STREET 2: STE 1000 CITY: PHOENIX STATE: AZ ZIP: 85004 15-12B 1 file001.txt CERTIFICATION UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 15 CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER SECTION 12(B) 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: 001-12410 SIMULA, INC. - -------------------------------------------------------------------------------- (Exact name of registrant as specified in its charter) 7822 SOUTH 46TH STREET PHOENIX, ARIZONA 85044-5354 (602) 631-4005 - -------------------------------------------------------------------------------- (Address, including zip code, and telephone number, including area code, of registrant's principal executive offices) 8% SENIOR SUBORDINATED CONVERTIBLE NOTES DUE 2004 - -------------------------------------------------------------------------------- (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)(i) [X] Rule 12g-4(a)(1)(ii) [ ] Rule 12h-3(b)(1)(ii) [ ] Rule 12g-4(a)(2)(i) [ ] Rule 12h-3(b)(2)(i) [ ] Rule 12g-4(a)(2)(ii) [ ] Rule 12h-3(b)(2)(ii) [ ] Rule 15d-6 Approximate number of holders of record as of the certification or notice date: 8% Senior Subordinated Convertible Notes due 2004: none Pursuant to the requirements of the Securities Exchange Act of 1934, Simula, Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person. SIMULA, INC. Date: January 5, 2004 By: /s/ Robert Mecredy ---------------------- Name: Robert Mecredy Title: President Instruction: This form is required by Rules 12g-4, 12h-3 and 15d-6 of the General Rules and Regulations under the Securities Exchange Act of 1934. The registrant shall file with the Commission three copies of Form 15, one of which shall be manually signed. It may be signed by an officer of the registrant, by counsel or by any other duly authorized person. The name and title of the person signing the form shall be typed or printed under the signature. -----END PRIVACY-ENHANCED MESSAGE-----