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)
8 1/2% Convertible Subordinated Debentures Due 2010
(Title of each class of securities covered by this Form)
Common Stock, $.05 par value; Rights to Purchase Shares of
Series A $5.00 Preferred Stock
(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 21, 1995 By: /s/ 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)
