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
PROFILE TECHNOLOGIES, INC.
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(Exact name of registratant as specified in its charter)
Delaware 91-1418002
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(State of incorporation or organization) (I.R.S. Employer Identification No.)
5 Strickland Place, Manhasset, NY 11030
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(Address of principal executive offices) (Zip Code)
If this Form relates to the registration of a class of debt securities and is
effective upon filing pursuant to General Instruction A.(c)(1), please check
the folloging 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
Instructions A.(c)(2), please check the following box. [ ]
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
None
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Securities to be registered pursuant to Section 12(g) of the Act:
.001 par value common stock
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(Title of class)
<PAGE>
Item 1. Description of Registrant's Securities to be Registered.
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$.001 par value common stock. This description is incorporated by
reference to the Registrant's registration statement No. 333-4714NY.
Item 2. Exhibits.
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1. Specimen stock certificate of $.001 par value common stock.
2. Constitutent instruments defining the rights of all holders of each
class of such securities are:
a. Articles of Incorporation of Registrant incorporated by reference
to Exhibit 3.1 to Registration Statement No. 333-4714NY.
b. Bylaws of Registrant incorporated by reference to Exhibit 3.4 to
Registration Statement No. 333-4714NY.
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.
PROFILE TECHNOLOGIES, INC.
Date: February 7, 1997 By: /s/ HENRY GEMINO
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Henry Gemino
Executive Vice President
EXHIBIT 1 - Specimen Stock Certificate
The stock certificate contains the following language on the front of the
certificate:
NUMBER (Corporate Logo) SHARES
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CUSIP
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PROFILE TECHNOLOGIES, INC.
THIS CERTIFIES THAT
IS THE RECORD HOLDER OF
fully paid and non-assessable Shares of the
par value of $.001 each
of the Common Stock of
Profile Technologies, Inc.
transferable on the books of the Corporation in person or by duly authorized
attorney upon surrender of this Certificate properly endorsed. This Certificate
is not valid until countersigned by the Transfer Agent and registered by the
Registrar.
IN WITNESS WHEREOF, the said Corporation has caused this Certificate to be
signed by its duly authorized officers and to be sealed with the Seal of the
Corporation.
(Corporate Seal)
Secretary President
<PAGE>
The stock certificate constains the following language on the back of the
certificate:
Notice: Signature must be guaranteed by a firm which is a
member of a registered national stock exchange, or by a
bank (other than a savings bank), or a trust company.
The following abbreviations, when used in the
inscription on the face of this certificate, shall be
construed as though they were written out in full
according to applicable laws of regulations:
TEN COM - as tenants in common UNIF GIFT MIN ACT - Custodian
TEN ENT - as tenants by the entireties -----------------
JF TEN - as joint tenants with right of (Cust) (Minor)
survivorship and not as tenants under the Uniform Gifts to Minors
in common Act
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(State)
Additional abbreviations may also be used though not in the above list.
For Value Received, hereby sell, assign and transfer unto
PLEASE INSERT SOCIAL SECURITY OR OTHER
IDENTIFYING NUMBER OF ASSIGNEE
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(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE OF ASSIGNEE)
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of the capital stock represented by the within certificate, and do hereby
irrevocably constitute and appoint
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to transfer the said stock on the books of the wtihin named Corporation with
full power of substitution in the premises.
Dated:
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NOTICE: THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS
WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR WITHOUT
ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER.
