Termination of Registration of a Class of Security Under Section 12(b) (15-12b)

 

 

UNITED STATES
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: 001-05270

 

AMIC Holdings, Inc. (formerly known as American Independence Corp.)

(Exact Name of Registrant as Specified in Its Charter)

 

485 Madison Avenue

New York, NY 10022

[phone]

(Address, Including Zip Code, and Telephone Number, Including Area Code, of Registrant's Principal Executive Offices)

 

Common Stock, par value $0.001 per share ¹

(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)	x
Rule 12g-4(a)(2)	¨
Rule 12h-3(b)(1)(i)	x
Rule 12h-3(b)(1)(ii)	¨
Rule 15d-6	¨
Rule 15d-22(b)	¨

  

 

Approximate number of holders of record as of the certification or notice date: Two

 

 

 

 

¹ As a result of the merger of American Independence Corp. with and into AMIC Holdings, Inc. on August 31, 2016, the shares of common stock, par value $0.01 per share, of American Independence Corp. ceased to be outstanding.

 

 

 

 

Pursuant to the requirements of the Securities Exchange Act of 1934 AMIC Holdings, Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.

 

 

Date: September 12, 2016	AMIC Holdings, Inc.
	By:	/s/ David T. Kettig
		Name: David T. Kettig Title: President

 

 

Instruction: This form is required by Rules 12g-4, 12h-3, 15d-6 and 15d-22 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.