American Caresource Holdings, Inc. - Securities Registration (section 12(b)) (8-A12B)
26 September 2008 - 10:21PM
Edgar (US Regulatory)
UNITES
STATES
SECURITIES
AND EXCHANGE COMMISSION
WASHINGTON,
DC 20549
________________
FORM
8-A
FOR
REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT
TO SECTION 12(b) OR 12(g) OF THE
SECURITIES
EXCHANGE ACT OF 1934
AMERICAN
CARESOURCE HOLDINGS, INC.
(Exact
name of registrant as specified in its charter)
Delaware
(State
of Incorporation)
|
20-0428568
(I.R.S.
Employer Identification No.)
|
5429 Lyndon B. Johnson Freeway, Suite 700, Dallas,
Texas 75240
|
(Address
of principal executive offices and zip
code)
|
Securities
to be registered pursuant to Section 12(b) of the Act:
Title
of each class
to
be so registered
|
Name
of each exchange on which
each
class is to be registered
|
|
|
Common
Stock, par value $.01 per
share
|
The
NASDAQ Stock Market LLC
|
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), check the following box.
x
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), check the following box.
o
Securities
Act registration statement file number to which this form relates:
Securities
to be registered pursuant to Section 12(g) of the
Act: None
|
Description
of Registrant’s Securities to be
Registered.
|
A
description of the registrant’s common stock, par value $0.01 per share, and
redeemable common stock purchase warrants is set forth under “Description of
Capital Stock” in the registrant’s Registration Statement on Form SB-2/A (File
No. 333-122820), filed with the Securities and Exchange Commission on December
5, 2005, and as may be amended after the date hereof, including any form of
prospectus contained therein filed pursuant to Rule 424(b) under the Securities
Act of 1933, as amended (the “Registration Statement”), which description is
incorporated herein by reference.
3.1(1)
|
Certificate
of Incorporation of American CareSource Holdings,
Inc.
|
3.3(2)
|
Amendment
to the Certificate of Incorporation of American CareSource Holdings, Inc.,
dated
May 25, 2005
|
3.4(2)
|
Amendment
to the Certificate of Incorporation of American CareSource Holdings, Inc.,
dated
June 2, 2005
|
3.5(3)
|
Amendment
to the Certificate of Incorporation of American CareSource Holdings,
Inc.,
dated November 14, 2005
|
3.6(4)
|
Certificate
of Incorporation of Ancillary Care Services – Group Health,
Inc.
|
3.7(4)
|
Certificate
of Incorporation of Ancillary Care Services – Medicare,
Inc.
|
3.8(4)
|
Certificate
of Incorporation of Ancillary Care Services – Worker’s Compensation,
Inc.
|
3.9(4)
|
Certificate
of Incorporation of Ancillary Care Services,
Inc.
|
4.1(5)
|
Amended
and Restated 2005 Stock Option Plan
|
4.2(2)
|
Specimen
Stock Certificate
|
10.1(4)
|
Form
of Registration Rights Agreement used in March 2006 private
placement
|
10.2(4)
|
Form
of Subscription Agreement used in March 2006 private
placement
|
(1)
|
Previously
filed with the Securities and Exchange Commission as an exhibit to
Amendment No. 1 to the Form SB-2 filed May 13, 2005 and incorporated
herein by reference.
|
(2)
|
Previously
filed with the Securities and Exchange Commission as an exhibit to
Amendment No. 5 to the Form SB-2 filed August 12, 2005 and incorporated
herein by reference.
|
(3)
|
Previously
filed with the Securities and Exchange Commission as an exhibit to
Amendment No. 8 to the Form SB-2 filed November 18, 2005 and
incorporated herein by reference.
|
(4)
|
Previously
filed with the Securities and Exchange Commission as an exhibit to the
Form 10-KSB filed March 31, 2006 and incorporated herein by
reference.
|
(5)
|
Previously
filed with the Securities and Exchange Commission as Exhibit A to
Amendment No. 1 to the Proxy Statement for the 2007 Annual Meeting of
Stockholders filed May 1, 2007 and incorporated herein by
reference.
|
SIGNATURE
Pursuant
to the requirements of Section 12 of the Securities Exchange Act of 1934, the
registrant has duly caused this registration statement to be signed on its
behalf by the undersigned, thereunto duly authorized.
|
American CareSource Holdings,
Inc.
|
|
|
|
|
|
|
By:
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/s/ David S. Boone
|
|
|
|
Name:
David S.
Boone
|
|
|
|
Title: Chief Executive
Officer
|
|
|
|
|
|
Date:
September 26, 2008
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