OMB APPROVAL
---------------------------
OMB Number: 3235-0167
Expires: October 31, 2004
Estimated average burden
hours per response.....1.50
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 333-02242
-------------------
BRIGHTPOINT, INC.
--------------------------------------------------------------------------------
(Exact name of registrant as specified in its charter)
501 AIRTECH PARKWAY
PLAINFIELD, INDIANA 46168
--------------------------------------------------------------------------------
(Address, including zip code, and telephone number, including area code, of
registrant's principal executive offices)
PLAN INTERESTS UNDER THE BRIGHTPOINT, INC. 401(K) PLAN
--------------------------------------------------------------------------------
(Title of each class of securities covered by this Form)
COMMON STOCK, $0.01 PAR VALUE
(OTHER THAN COMMON STOCK RELATING TO THE BRIGHTPOINT, INC. 401(K) PLAN)
PREFERRED SHARE PURCHASE RIGHTS
--------------------------------------------------------------------------------
(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) [ ] Rule 12h-3(b)(1)(i) [X]
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 [X]
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 BRIGHTPOINT,
INC. has caused this certification/notice to be signed on its behalf by the
undersigned duly authorized person.
Date: May 11, 2004 By: /s/ Steven E. Fivel
------------------------------ ------------------------------------
Name: Steven E. Fivel
Title: Executive Vice President,
General Counsel and Secretary
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
SEC 2069 (01-02) DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER.