UNITED STATES 

SECURITIES AND EXCHANGE COMMISSION 

Washington, D.C. 20549 

OMB APPROVAL 

OMB Number: 3235-0056 

Expires: July 31, 2025 

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hours per response.............3.0 

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 file reports pursuant 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 financial statements that are 

audited in accordance with the standards of, and by an accounting firm 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 file an annual report pursuant to Section 15(d) of the 

Act for its last fiscal year, except for the fact that the registration statement on this form will 

become effective before such report is required to be filed, an annual report for such fiscal 

year shall nevertheless be filed within the period specified 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 certification from the national securities exchange listed on this 

form or the filing 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 filing of the Form 8-A with the Commission, receipt by the 

Commission of certification from the national securities exchange listed on this 

form or effectiveness of the Securities Act registration statement relating to the 

class of securities. 

SEC 1922 (5-19) Potential 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 

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(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 filing 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 filing 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: 

(1) For the registration of a class of securities under Section 12(b), upon the latest of 

the filing of the Form 8-A with the Commission, the qualification of the 

Regulation A offering statement or the receipt by the Commission of certification 

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 filing of the Form 8-A and qualification of the Regulation A offering 

statement. 

(Note: Registration pursuant to paragraph (e) of this form is not permitted if the filing of the 

Form 8-A and, where applicable, the receipt by the Commission of certification from the national 

securities exchange listed on this form occurs more than five calendar days after the qualification 

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 filing 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 filing of the registration statement. The definitions 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 filled in, but only as a guide in the preparation 

of the registration 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 specified in Rule 12b-l3. 

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D. Signature and Filing of Registration Statement. 

Eight complete copies of the registration statement, including all papers and documents filed as a 

part thereof (other than exhibits) shall be filed with the Commission and at least one such copy 

shall be filed with each exchange on which the securities are to be registered. Exhibits shall be 

filed with the Commission and with any exchange in accordance with the Instructions as to 

Exhibits. At least one copy of the registration statement filed with the Commission and one filed 

with each exchange shall be manually signed. Unsigned copies shall be conformed. 

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OMB APPROVAL 

OMB Number: 3235-0056 

Expires: July 31, 2025 

Estimated average burden 

hours per response.............3.0 

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 specified in its charter) 

(State or other jurisdiction of incorporation or (I.R.S Employer Identification No.) 

organization) 

(Address of principal executive offices) (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 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. 

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Securities Act registration statement or Regulation A offering statement file 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) 

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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 filing with the Commission, such description may be incorporated by reference to such 

other filing in answer to this item. If such description will be included in a form of prospectus or 

an offering circular subsequently filed 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 offering 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 filed 

with such exchange, copies of the description shall be filed with copies of the application filed 

with the exchange. 

Item 2. Exhibits. 

List below all exhibits filed 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 officer under such officer’s 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 defining 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, must be filed as exhibits with each copy of the registration statement filed with the 

Commission or with an exchange, subject to Rule 12b-23(c) regarding incorporation of exhibits 

by reference. 

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