United States
Securities and Exchange Commission
Washington, D.C. 20449
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: 0-20954
Cocensys, Inc.
(Exact name of registrant as specified in its charter)
213 Technology Drive
Irvine, CA 92618
(949) 753-6100
(Address, including zip code, and telephone number,
including area code, of registrant's principal executive offices)
Common Stock, $0.001 Par Value Per Share
(including the associated rights to purchase Series A Junior Preferred Stock)
(Title of each class of securities covered by this Form)
None
(Title 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) |X|
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:1
<PAGE>
Pursuant to the requirements of the Securities Exchange Act of
1934, as amended, CoCensys, Inc. has caused this certification/notice to be
signed on its behalf by the undersigned duly authorized person.
COCENSYS, INC.
Date: September 29, 1999 By: /s/ Stuart D. Baker
---------------------------
Name: Stuart D. Baker
Title: Vice President
2
