UNITED STATES OMB APPROVAL
SECURITIES AND EXCHANGE COMMISSION ____________________________
WASHINGTON, D.C. 20549 | OMB Number: 3235-0167 |
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FORM 15 | Expires: November 30, 1995|
| Estimated average burden |
| hours per response... 1.50|
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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 1-7941
Perry Drug Stores, Inc.
(Exact name of registrant as specified in its charter)
5400 Perry Drive, P.O. Box 436021,
Pontiac MI 48343-6021; (810) 334-1300
(Address, including zip code, and telephone number,
including area code, of registrant's principal executive
offices)
Rights to Purchase Shares of Series A $5.00 Preferred Stock
(Title of each class of securities covered by this Form)
(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: 0
Pursuant to the requirements of the Securities
Exchange Act of 1934 Perry Drug Stores, Inc. has caused
this certification/notice to be signed on its behalf by
the undersigned duly authorized person.
Date: March 24, 1995 By: Robert A. Berlow
Executive 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. 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.
SEC 2069 (8-93)
