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 DUTYTO FILE REPORTS UNDER SECTIONS 13 AND 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934.
CommissionFileNumber001-34930
ExamWorks Group, Inc.
(Exactnameofregistrantasspecifiedinitscharter)
3280 Peachtree Road, N.E.
Suite 2625
Atlanta, GA 30305
(404) 952-2400
(Address,includingzipcode,andtelephonenumber,includingareacode,ofregistrant’sprincipalexecutiveoffices)
CommonStock,$0.0001parvalueper share
(TitleofeachclassofsecuritiescoveredbythisForm)
None
(Titlesofallotherclassesofsecuritiesforwhichadutytofilereports undersection13(a)or15(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) | ☒ | |||
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: One
Pursuant to the requirements of the Securities Exchange Act of 1934, ExamWorks Group, Inc. has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.
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| ExamWorks Group, Inc. |
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Date: August 8, 2016 | By: | /s/ J. Miguel Fernandez de Castro |
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| J. Miguel Fernandez de Castro |
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Chief Financial Officer and Senior Executive | |||
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| Vice President |
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