SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
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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
PacificHealth Laboratories, Inc.
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(Exact Name of Registrant as Specified in Its Charter)
Delaware 23-3367588
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(State of Incorporation or Organization) (IRS Employer
Identification No.)
460 Route 9 North, Woodbridge, NJ 07095
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(Address of Principal Executive Offices) (Zip Code)
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), please 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), please check the following box.|X|
Securities Act registration statement file number to which this form relates:
333-36379
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(If Applicable)
<PAGE>
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
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Securities to be Registered pursuant to Section 12(g) of the Act:
Common Stock, $.0025 par value
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(Title of Class)
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(Title of Class)
Item 1. Description of Securities to be Registered.
Common Stock, $.0025 par value per share. Holders of Common Stock are
entitled to one vote for each share of Common Stock owned of record on all
matters to be voted on by stockholders, including the election of directors.
Holders of Common Stock do not have cumulative voting rights and, accordingly,
the holders of more than 50% of the outstanding shares can elect the entire
Board of Directors. The holders of Common Stock are entitled, upon liquidation
or dissolution of the Company, to receive pro rata all assets remaining
available for distribution to stockholders. The Common Stock has no preemptive
or other subscription rights, and there are no conversion rights or redemption
provisions. All outstanding shares of Common Stock are validly issued, fully
paid, and nonassessable.
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Item 2. Exhibits.
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Exhibit No. Description Location
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<S> <C> <C>
1 Certificate of Incorporation of the Incorporated by reference to Exhibit 3.1
Registrant and all amendments thereto to Registrant's Registration Statement on
Form SB-2, Registration Number 333-36379
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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, thereto duly authorized.
PacificHealth Laboratories, Inc.
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(Registrant)
Date December 11, 1997 By: /s/ Jonathan D. Rahn
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Name: Jonathan D. Rahn
Title: Executive Vice President
