U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 15
CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION
UNDER SECTION 12(B) 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
Xerographic Laser Images Corporation
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(Exact name of registrant as specified in its charter)
101 Billerica Avenue, 5 Billerica Park
North Billerica, Massachusetts 01862
(978) 670-5999
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(Address, including zip code, and telephone number,
including area code, of registrant's principal
executive offices)
Common Stock, Class A Common Stock Purchase Warrant
and Series A Preferred Stock
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(Title of each class of securities covered by this Form)
None
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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)(ii) ( )
Rule 12g-4(a)(1)(ii) (x) 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 (1)
Pursuant to the requirements of the Securities Exchange Act of 1934,
Xerographic Laser Images Corporation has caused this certification/notice to
be signed on its behalf by the undersigned duly authorized person.
Date: August 12, 1998 By: /s/ Anthony D. D'Amelio
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Name: Anthony D. D'Amelio
Title: 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.
