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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
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FORM 8-A/A
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(b) OR 12(g) OF THE
SECURITIES EXCHANGE ACT OF 1934
FPIC INSURANCE GROUP, INC.
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(Exact name of registrant as specified in its charter)
Florida 59-3359111
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(State of Incorporation (IRS Employer
or Organization) Identification No.)
1000 Riverside Avenue, Suite 800
Jacksonville, Florida 32204
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(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 so Registered Each Class is to be Registered
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None
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If this Form relates to the registration of a class of debt securities and is
effective filing pursuant to General Instruction A(c)(1) please check the
following box. [ ]
If this Form relates to the registration of a class of debt securities and is
to become effective simultaneously with the effectiveness of a concurrent
registration statement under the Securities Act of 1933 pursuant to General
Instruction A(c)(2) please check the following box. [ ]
Securities to be registered pursuant to Section 12(g) of the Act:
Common Stock, par value $.10
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(Title of class)
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Item 1. Description of Registrant's Securities to be Registered
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The description of the Common Stock of FPIC Insurance Group, Inc., a
Florida corporation (the "Registrant"), par value $.10 per share (the "Common
Stock") is hereby incorporated by reference to the "Description of Capital
Stock" section contained in the Registrant's Registration Statement on Form
S-1, as amended (File No. 333-4585), which was first filed with the Securities
and Exchange Commission (the "Commission") on May 24, 1996.
Item 2. Exhibits
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EXHIBIT
NUMBER EXHIBIT
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3(a) Restated Articles of Incorporation of the Registrant
(incorporated by reference to Exhibit 3(a) of the
Registrant's Registration Statement on Form S-4
(File No. 333-2040), first filed with the Commission
on March 7, 1996).
3(b) Bylaws of the Registrant (incorporated by reference to
Exhibit 3(b) of the Registrant's Registration
Statement on Form S-4 (File No. 333-2040), first filed
with the Commission on March 7, 1996).
4 Specimen certificate of the Common Stock to be
registered hereunder (incorporated by reference to
Exhibit 4 of the Registrant's Registration Statement
on Form S-1 (File No. 333-4585), first filed with the
Commission on May 24, 1996).
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.
FPIC Insurance Group, Inc.
By: /s/ Steven R. Smith
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Steven R. Smith
Executive Vice President and
Chief Operating Officer
Dated: July 30, 1996
