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 0-26502
COMMUNITY CARE OF AMERICA, INC.
(EXACT NAME OF REGISTRANT AS SPECIFIED IN ITS CHARTER)
3050 NORTH HORSESHOE DRIVE, SUITE 260, NAPLES, FLORIDA 33942
(ADDRESS, INCLUDING ZIP CODE, AND TELEPHONE NUMBER, INCLUDING AREA CODE,
OF REGISTRANT'S PRINCIPAL EXECUTIVE OFFICES)
COMMON STOCK, $.0025 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) 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) [X]
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
COMMUNITY CARE OF AMERICA, INC. HAS CAUSED THIS CERTIFICATION/NOTICE TO BE
SIGNED ON ITS BEHALF BY THE UNDERSIGNED DULY AUTHORIZED PERSON.
DATE: SEPTEMBER 29, 1997 BY: /s/ W. Bradley Bennett
--------------------------- -----------------------------
W. Bradley Bennett
Executive Vice President - Chief
Accounting Officer
