<PAGE> 1
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 000-19454
-------------
ANERGEN, INC.
- --------------------------------------------------------------------------------
(Exact name of registrant as specified in its charter)
301 PENOBSCOT DRIVE, REDWOOD CITY, CA 94063, (650) 361-8901
- --------------------------------------------------------------------------------
(Address, including zip code, and telephone number, including area
code, of registrant's principal executive offices)
COMMON STOCK, $.001 PAR VALUE
- --------------------------------------------------------------------------------
(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) or designate the appropriate rule
provision(s) relied upon the terminate or suspend duty by 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) [X]
Approximate number of holders of record as of the certification or notice date:
ONE (1)
Pursuant to the requirements of the Securities Exchange Act of 1934,
Anergen, Inc. has caused this certification/notice to be signed on its behalf by
the undersigned duly authorized person.
Date: FEBRUARY 11, 1999 By: /s/ BARRY SHERMAN
--------------------------------
Name: Barry M. Sherman, M.D.
Title: President, Chief Executive
Officer
Instructions: 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 duly authorized person. The name and title of the person
signing the form shall be typed or printed under the signature.
