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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 0-14587
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GENETICS INSTITUTE, INC.
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(Exact name of registrant as specified in its charter)
87 CambridgePark Drive, Cambridge, MA 02140 (617) 876-1170
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(Address, including zip code, and telephone number, including area code, of
registrant's principal executive offices)
Common Stock Purchase Warrants
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(Title of each class of securities covered by this Form)
(1) Depositary Shares, each representing one share of Common Stock, $0.01 par
value per share*
(2) Common Stock, $0.01 par value per share
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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) /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: 0
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Pursuant to the requirements of the Securities Exchange Act of 1934
Genetics Institute, Inc. has caused this certification/notice to be signed on
its behalf by the undersigned duly authorized person.
Date: June 3, 1996 By: /s/ Garen G. Bohlin
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Garen G. Bohlin, Executive Vice President and
Chief Financial Officer
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 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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* The Depositary Shares of Genetics Institute, Inc., represent one share of
Common Stock, $0.01 par value, of Genetics Institute, Inc., subject to a
certain stock purchase option held by AHP Biotech Holdings, Inc., and are
evidenced by a depositary receipt.
