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Commission File Number 001-14213
InterCept, Inc.
(Exact
name of registrant as specified in its charter)
3150 Holcomb Bridge Road, Suite 200, Atlanta, Georgia 30071-1370 (770) 248-9600
(Address,
including zip code, and telephone number, including area code, of registrants
principal executive offices)
Common Stock, no 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)(i) [ ] | ||||
Rule 12g-4(a)(1)(ii) [ ] | Rule 12h-3(b)(1)(ii) [ ] | ||||
Rule 12g-4(a)(2)(i) [ ] | Rule 12h-3(b)(2)(i) [ ] | ||||
Rule 12g-4(a)(2)(ii) [ ] | Rule 12h-3(b)(2)(ii) [ ] | ||||
Rule 15d-6 [ ] |
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 InterCept, Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.
Date: November 8, 2004 | /s/ Jonathan R. Coe | ||||
By: Jonathan R. Coe | |||||
Title: Senior Vice President |
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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
SEC 2069 (09-03)
Form 15
NYB594174