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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
SECTIONS 13 AND 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934.
Commission File Number: 33-50239
American Medical International, Inc.
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(Exact name of registrant as specified in its charter)
14001 Dallas Parkway, Suite 200, Dallas, Texas 75380-9088 (214) 789-2200
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(Address, including zip code, and telephone number, including area code, of
registrant's principal executive offices)
See Schedule 1 Attached Hereto, Consisting of One Page
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(Title of each class of securities covered by this Form)
None
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(Title 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) / / 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: SEE SCHEDULE 1 ATTACHED HERETO, CONSISTING OF ONE PAGE
Pursuant to the requirements of the Securities Exchange Act of 1934 (NAME
OF REGISTRANT AS SPECIFIED IN CHARTER) has caused this certification/notice to
be signed on its behalf by the undersigned duly authorized person.
Date: May 19, 1995 By: /s/ Richard B. Silver
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Richard B. Silver
Vice President and Assistant Secretary
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.
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SCHEDULE 1
TO
FORM 15 OF AMERICAN MEDICAL INTERNATIONAL, INC.
DATED MAY 19, 1995
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NUMBER OF
HOLDERS AS
ISSUER INSTRUMENT OF 5/18/95
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<S> <C> <C>
American Medical International, Inc. 9 1/2% Senior Subordinated Notes due 2006 0
American Medical International, Inc. 11% Senior Notes due 2000 9
American Medical International, Inc. 13 1/2% Senior Subordinated Notes due 2001 21
American Medical International, Inc. 15% Junior Subordinated Discount
Debentures due 2005 2
American Medical International, Inc. 8 1/4% Convertible Subordinated Debentures
due April 1, 2008 0
American Medical International, Inc. 9 1/2% Convertible Subordinated Debentures
due November 15, 2001 0
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