-----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, JbSF+TnOiPff1Pju7QYlS2j+PMBerST3TRIdIBe+adwKZ8x5zXHtuZowSj3ym88f Wm/IIgQRpmJfVd5Pa7cpLw== 0000931763-98-000856.txt : 19980402 0000931763-98-000856.hdr.sgml : 19980402 ACCESSION NUMBER: 0000931763-98-000856 CONFORMED SUBMISSION TYPE: 15-12G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19980401 SROS: NONE FILER: COMPANY DATA: COMPANY CONFORMED NAME: GULF SOUTH MEDICAL SUPPLY INC CENTRAL INDEX KEY: 0000889885 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 640831411 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 15-12G SEC ACT: SEC FILE NUMBER: 000-23540 FILM NUMBER: 98585727 BUSINESS ADDRESS: STREET 1: ONE WOODGREEN PLACE CITY: MADISON STATE: MS ZIP: 39110 BUSINESS PHONE: 6018565900 MAIL ADDRESS: STREET 1: 426 CHRISTINE DR CITY: RIDGELAND STATE: MS ZIP: 39157 15-12G 1 FORM 15 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 Section 13 and 15(d) of the Securities Exchange Act of 1934 Commission File Number: 0-23540 GULF SOUTH MEDICAL SUPPLY, INC. ----------------------------------------------------------- (Exact name of registrant as specified in its charter) ON WOODGREEN PLACE MADISON, MISSISSIPPI 39110 (601) 856-5900 --------------------------------------------------------------- (Address, including zip code, and telephone number, including area code, of registrant's principal executive offices) COMMON STOCK, $0.01 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)(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)(1)(ii) [ ] Rule 12g-4(a)(2)(ii) [ ] Rule 12h-3(b)(2)(ii) [ ] Rule 12h-3(b)(1)(i) [X] Rule 15d-6 [ ] Approximate number of holders of record as of the certification or notice date: 1 There is one holder of record of the class of securities listed above as of the date hereof. Effective as of March 26, 1998, Gulf South Medical Supply, Inc. ("Gulf South") merged with and into a wholly owned subsidiary of Physician Sales & Service, Inc. ("PSS"), with Gulf South being the surviving corporation and becoming a wholly owned subsidiary of PSS. In connection therewith, all of the Common Stock of Gulf South was converted into the right to receive securities of PSS, which was renamed "PSS World Medical, Inc." Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, PSS World Medical, Inc. (as successor to Gulf South) has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person. PSS WORLD MEDICAL, INC. Date: March 30, 1998 By: /s/ Fred Elefant ------------------------------------ Fred Elfant Secretary and General Counsel -----END PRIVACY-ENHANCED MESSAGE-----