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 0-17961
Check Express, Inc.
(Exact name of registrant as specified in this charter)
101 East Kennedy Blvd., Suite 3800
Tampa, Florida 33602
(813) 223-3338
(Address, including zip code, and telephone number, including area
code, of registrant's principal executive offices)
Common Stock
Title of each class of securities covered by this Form
None
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)(ii) [ ]
Rule 12g-4(a)(1)(ii) [ ] Rule 12h-3(b)(2)(i) [ ]
Rule 12g-4(a)(2)(i) [ ] Rule 12h-3(b)(2)(ii) [ ]
Rule 12g-4(a)(2)(ii) [ ] Rule 15d-6 [ ]
Rule 12h-3(b)(1)(i) [ ]
Approximate number of holders of record as of the certification or notice
date: One
Pursuant to the requirements of the Securities Exchange Act of 1934, Check
Express, Inc. has caused this certification/notice to be signed on its
behalf by the undersigned duly authorized person.
DATE: February 10, 1996 By: /s/ Thomas E. Larson
----------------- ----------------------------------------
Thomas E. Larson, Vice President
- Finance
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.