Termination of Registration of a Class of Security Under Section 12(g) (15-12g)
April 10 2023 - 7:01AM
Edgar (US Regulatory)
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: 001-40028
SIGNIFY HEALTH, INC.
(Exact name of registrant as specified in its charter)
4055 Valley
View Ln, Suite 700
Dallas, TX 75244
(855) 984-5121
(Address, including zip code, and telephone number, including area code, of registrants principal executive offices)
Class A common stock, par value $0.01 per share
(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:
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Rule 12g-4(a)(1) |
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☒ |
Rule 12g-4(a)(2) |
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Rule 12h-3(b)(1)(i) |
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Rule 12h-3(b)(1)(ii) |
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☐ |
Rule 15d-6 |
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Rule 15d-22(b) |
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☐ |
Approximate number of holders of record as of the certification or notice date: One (1) holder
Pursuant to the requirements of the Securities Exchange Act of 1934, Signify Health, Inc.
has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.
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SIGNIFY HEALTH, INC. |
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Date: April 10, 2023 |
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By: |
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/s/ Steve Senneff |
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Name: Steve Senneff |
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Title: President, Chief Financial and Administrative Officer |
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