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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
SECTION 13 AND 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934.
Commission File Number 000-22771
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Centennial HealthCare Corporation
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(Exact name of registrant as specified in its charter)
400 Perimeter Center Terrace, Suite 650, Atlanta, Georgia 30346 (770) 698-9040
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(Address, including zip code, and telephone number, including area code, of
registrant's principal executive offices)
Common Stock, par value $.01 per share
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(Title of each class of securities covered by this Form)
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(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) [ ]
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: One
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Pursuant to the requirements of the Securities Exchange Act of 1934,
Centennial HealthCare Corporation has caused this certification/notice to be
signed on its behalf by the undersigned duly authorized person.
Date: June 14, 2000 By: /s/ Daryl R. Griswold
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Daryl R. Griswold,
Assistant Secretary
