Termination of Registration of a Class of Security Under Section 12(g) (15-12g)
March 19 2018 - 12:34PM
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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
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000-55702
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Bagger
Dave’s Burger Tavern Inc.
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(Exact name of registrant as specified in its
charter)
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807 West Front Street,
Suite B, Traverse City, Michigan 49684
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(Address,
including zip code, and telephone number, including area code, of registrant’s principal executive offices)
Common
Stock
(Title
of each class of securities covered by this Form)
(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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[X]
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Rule
12g-4(a)(2)
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[ ]
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Rule
12h-3(b)(1)(i)
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[ ]
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Rule
12h-3(b)(1)(ii)
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[ ]
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Rule
15d-6
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[ ]
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Rule
15d-22(b)
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[ ]
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Approximate
number of holders of record as of the certification or notice date:
233
Pursuant
to the requirements of the Securities Exchange Act of 1934
(Name of registrant as specified in charter)
has caused this
certification/notice to be signed on its behalf by the undersigned duly authorized person.
Date:
March 19, 2018
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By:
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/s/
T. Michael Ansley
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T.
Michael Ansley, President
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Instruction:
This form is required by Rules 12g-4, 12h-3 and 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.
SEC
2069 (08-11)
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Persons
who
respond
to
the
collection
of
information contained
in
this form
are
not
required
to
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