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.
(Address,
including zip code, and telephone number, including area code, of
registrant's principal executive offices)
Preferred
Share Purchase Rights
(Title
of each class of securities covered by this Form)
Common
Stock, par value $1.00 per share
(Titles
of all other classes of securities for which a duty to file reports under
section 13(a) and 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)
o
Rule
12h-3(b)(1)(i)
o
Rule
12h-3(b)(1)(ii)
o
Rule 15d-6
o
Approximate
number of holders of record as of the certification on notice date:-0-
Pursuant
to the requirements of the Securities Exchange Act of 1934, HNI Corporation has
caused this certificiation/notice to be signed on its behalf by the undersigned
duly authorized person.
Instruction: This form is
required by Rules 12g-4, 12h-3 and 15d-6 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.
Dates Referenced Herein and Documents Incorporated by Reference
