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UNITED STATES OMB APPROVAL
SECURITIES AND EXCHANGE COMMISSION ----------------------------
Washington, D.C. 20549 OMB Number: 3235-0167
Expires: November 30, 1995
Estimated Average Burden
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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 1-5292
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MEM COMPANY, INC.
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(Exact name of registrant as specified in its charter)
UNION STREET EXTENSION, NORTHVALE, NEW JERSEY 07647, (201)-767-0100
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(Address, including zip code, and telephone number, including area code,
of registrant's principal executive offices)
COMMON STOCK, PAR VALUE $0.05 PER SHARE
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(Title of each class of securities covered by this form)
NONE
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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
provisions(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: One
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Pursuant to the requirements of the Securities Exchange Act of 1934, as
amended, MEM Company, Inc. has caused this certification/notice to be signed
on its behalf by the undersigned duly authorized person.
Date: December 19, 1996 By: /s/ John R. Jackson
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John R. Jackson
Vice 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, as
amended. 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 office 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.
