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Fillable Printable Form 8-A

Fillable Printable Form 8-A

Form 8-A

Form 8-A

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 8-A
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(b) OR (g) OF THE
SECURITIES EXCHANGE ACT OF 1934
GENERAL INSTRUCTIONS
A. Rule as to Use of Form 8-A.
(a) Subject to paragraph (b) below, this form may be used for registration pursuant to Section 12(b) or (g) of the
Securities Exchange Act of 1934 of any class of securities of any issuer which is (1) required to le reports pur-
suant to Section 13 or 15(d) of that Act, (2) is concurrently qualifying a Tier 2 offering statement relating to that
class of securities using the Form S-1 or Form S-11 disclosure models that includes nancial statements that
are audited in accordance with the standards of, and by an accounting rm that is registered with, the Public
Company Accounting Oversight Board (United States), or (3) pursuant to an order exempting the exchange on
which the issuer has securities listed from registration as a national securities exchange.
(b) If the registrant would be required to le an annual report pursuant to Section 15(d) of the Act for its last s-
cal year, except for the fact that the registration statement on this form will become effective before such report
is required to be led, an annual report for such scal year shall nevertheless be led within the period speci ed
in the appropriate annual report form.
(c) If this form is used for the registration of a class of securities under Section 12(b), it shall become effective:
(1) If a class of securities is not concurrently being registered under the Securities Act of 1933 (15
U.S.C. 77a et seq.) (“Securities Act”), upon the later of receipt by the Commission of certi cation from the
national securities exchange listed on this form or the ling of the Form 8-A with the Commission; or
(2) If a class of securities is concurrently being registered under the Securities Act, upon the latest of
the ling of the Form 8-A with the Commission, receipt by the Commission of certi cation from the national
securities exchange listed on this form or effectiveness of the Securities Act registration statement relating to
the class of securities.
(d) If this form is used for the registration of a class of securities under Section 12(g), it shall become effective:
(1) If a class of securities is not concurrently being registered under the Securities Act, upon the ling of
the Form 8-A with the Commission; or
(2) If class of securities is concurrently being registered under the Securities Act, upon the later of the
ling of the Form 8-A with the Commission or the effectiveness of the Securities Act registration statement
relating to the class of securities.
(e) Notwithstanding the foregoing in paragraphs (c) and (d) of this form, if this form is used for registration of a
class of securities being offered under Regulation A, it shall become effective:
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(1) For the registration of a class of securities under Section 12(b), upon the latest of the ling of the
Form 8-A with the Commission, the quali cation of the Regulation A offering statement or the receipt by the
Commission of certi cation from the national securities exchange listed on this form; or
(2) For the registration of a class of securities under Section 12(g), upon the later of the ling of the
Form 8-A and quali cation of the Regulation A offering statement.
(Note: Registration pursuant to paragraph (e) of this form is not permitted if the ling of the Form 8 A and,
where applicable, the receipt by the Commission of certi cation from the national securities exchange listed on
this form occurs more than ve calendar days after the quali cation of the Regulation A offering statement)
B. Application of General Rules and Regulations.
(a) The General Rules and Regulations under the Act contain certain general requirements which are applicable
to registration on any form. These general requirements should be carefully read and observed in the preparation
and ling of registration statements on this form.
(b) Particular attention is directed to Regulation l2B which contains general requirements regarding matters
such as the kind and size of paper to be used, legibility, information to be given whenever the title of securities
is required to be stated, incorporation by reference and the ling of the registration statement. The de nitions
contained in Rule 12b-2 should be especially noted.
C. Preparation of Registration Statement.
This form is not to be used as a blank form to be lled in, but only as a guide in the preparation of the registra-
tion statement on paper meeting the requirements of Rule l2b-12. The registration statement shall contain the
item numbers and captions, but the text of the items may be omitted. The answers to the items shall be prepared
in the manner speci ed in Rule 12b-l3.
D. Signature and Filing of Registration Statement.
Eight complete copies of the registration statement, including all papers and documents led as a part thereof
(other than exhibits) shall be led with the Commission and at least one such copy shall be led with each
exchange on which the securities are to be registered. Exhibits shall be led with the Commission and with
any exchange in accordance with the Instructions as to Exhibits. At least one copy of the registration statement
led with the Commission and one led with each exchange shall be manually signed. Unsigned copies shall be
conformed.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 8-A
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(b) OR (g) OF THE
SECURITIES EXCHANGE ACT OF 1934
_________________________________________
(Exact name of registrant as speci ed in its charter)
______________________________ ______________________
(State or other jurisdiction of incorporation or organization) (I.R.S. Employer
Identi cation No.)
_______________________________ ____________________
(Address of principal executive of ces) (Zip Code)
Securities to be registered pursuant to Section 12(b) of the Act:
Title of each class Name of each exchange on which
to be so registered each class is to be registered
________________________ __________________________
________________________ __________________________
________________________ __________________________
If this form relates to the registration of a class of securities pursuant to Section 12(b) of the Exchange Act and
is effective pursuant to General Instruction A.(c) or (e), check the following box.
If this form relates to the registration of a class of securities pursuant to Section 12(g) of the Exchange Act and
is effective pursuant to General Instruction A.(d) or (e), check the following box.
If this form relates to the registration of a class of securities concurrently with a Regulation A offering, check
the following box.
Securities Act registration statement or Regulation A offering statement le number to which this form relates:
______________________(if applicable)
Securities to be registered pursuant to Section 12(g) of the Act:
_________________________________________________________________________
(Title of class)
______________________________________________________________________________
(Title of class)
Persons who are to 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.
SEC1922 (6-15) 3 of 4
OMB Number: 3235-0056
Expires: June 30, 2018
Estimated average burden
hours per response . . . . . . . 3.0
OMB APPROVAL
INFORMATION REQUIRED IN REGISTRATION STATEMENT
Item 1. Description of Registrant’s Securities to be Registered.
Furnish the information required by Item 202 of Regulation S-K (§229.202 of this chapter), as applicable.
Instruction. If a description of the securities comparable to that required here is contained in any prior ling
with the Commission, such description may be incorporated by reference to such other ling in answer to this
item. If such description will be included in a form of prospectus or an offering circular subsequently led by
the registrant pursuant to Rule 424(b) under the Securities Act (§230.424(b) of this chapter) or Rule 253(g) of
Regulation A (§ 230.253(g) of this chapter), this registration statement shall state that such prospectus or offer-
ing circular shall be deemed to be incorporated by reference into the registration statement. If the securities are
to be registered on a national securities exchange and the description has not previously been led with such
exchange, copies of the description shall be led with copies of the application led with the exchange.
Item 2. Exhibits.
List below all exhibits led as a part of the registration statement:
Instruction. See the instructions as to exhibits, set forth below.
SIGNATURE
Pursuant to the requirements of Section l2 of the Securities Exchange Act of 1934, the registrant has duly
caused this registration statement to be signed on its behalf by the undersigned, thereto duly authorized.
(Registrant) ___________________________________________________________
Date ______________________________________
By __________________________________________________________________
*Print the name and title of the signing of cer under such of cers signature.
INSTRUCTIONS AS TO EXHIBITS
If the securities to be registered on this form are to be registered on an exchange on which other securities of
the registrant are registered, or are to be registered pursuant to Section 12(g) of the Act, copies of all constituent
instruments de ning the rights of the holders of each class of such securities, including any contracts or other
documents which limit or qualify the rights of such holders, shall be led as exhibits with each copy of the reg-
istration statement led with the Commission or with an exchange, subject to Rule 12b-32 regarding incorpora-
tion of exhibits by reference.
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