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Diversicare Healthcare Services, Inc. – ‘15-12B’ on 11/22/21

On: Monday, 11/22/21, at 5:16pm ET · Effective: 11/22/21 · Accession #: 1628280-21-23992 · File #: 1-12996

  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

11/22/21  Diversicare Healthcare Svcs, Inc. 15-12B     11/22/21    1:15K                                    Workiva Inc Wde… FA01/FA

Certification of a Termination of Registration of a Class of Securities — Form 15 — § 12(b) – SEA’34

Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 15-12B      Certification of a Termination of Registration of   HTML     11K 
                a Class of Securities

This is an HTML Document rendered as filed. [ Alternative Formats ]

<! C: C:

Document

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: 001-12996


Diversicare Healthcare Services, Inc.
(Exact name of registrant as specified in its charter)


1621 Galleria Boulevard Brentwood, Tennessee 37027 (615)-771-7575
(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)


Common Stock, $0.01 par value 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:

Rule 12g-4(a)(1) ☑

Rule 12g-4(a)(2) ☐

Rule 12h-3(b)(1)(i) ☑

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: 1

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

DIVERSICARE HEALTHCARE SERVICES, INC.

Date: November 22, 2021

By: /s/ Kerry D. Massey

Name: Kerry D. Massey

Title: Chief Financial Officer

Dates Referenced Herein and Documents Incorporated by Reference

This ‘15-12B’ Filing	Date	Other Filings

Filed on / Effective on:	11/22/21	4, S-8 POS
		List all Filings

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Filing Submission 0001628280-21-023992 – Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)

Diversicare Healthcare Services, Inc. – ‘15-12B’ on 11/22/21

On: Monday, 11/22/21, at 5:16pm ET · Effective: 11/22/21 · Accession #: 1628280-21-23992 · File #: 1-12996

Previous ‘15-12B’: ‘15-12B’ on 5/19/14 · Latest ‘15-12B’: This Filing

Certification of a Termination of Registration of a Class of Securities — Form 15 — § 12(b) – SEA’34Filing Table of Contents

This is an HTML Document rendered as filed. [ Alternative Formats ]

Dates Referenced Herein and Documents Incorporated by Reference

Certification of a Termination of Registration of a Class of Securities — Form 15 — § 12(b) – SEA’34

Filing Table of Contents