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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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FORM 8-A
FOR REGISTRATION OF CERTAIN CLASSES OF
SECURITIES PURSUANT TO SECTION 12(b) OR
(g) OF THE SECURITIES EXCHANGE ACT OF 1934
CHEM INTERNATIONAL, INC.
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(Exact name of registrant as specified in its charter)
DELAWARE 13-3035216
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(State of incorporation or organization) (IRS Employee
Identification #)
201 Route 22, Hillside, New Jersey 07205
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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
___________________ ______________________________
NONE NONE
___________________ ______________________________
___________________ ______________________________
If this Form relates to the registration of a class of debt securities and is to
become effective upon filing pursuant to General Instruction A.(c)(1), check the
following box: [ ]
If this Form relates to the registration of a class of debt securities and is to
become effective simultaneously with effectiveness of a concurrent registration
statement under the Securities Act of 1933 pursuant to General Instruction
A.(c)(2), check the following box: [ ]
Securities to be registered pursuant to Section 12(g) of the Act:
COMMON STOCK, PAR VALUE $.002 PER SHARE
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(Title of Class)
CLASS "A" REDEEMABLE COMMON STOCK PURCHASE WARRANTS
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(Title of Class)
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Item 1. Description of Registrant's Securities to be Registered.
A description of the Registrant's securities to be registered is
incorporated herein by reference to the section entitled "Description of
Securities" in the Preliminary Prospectus forming a part of the
Registrant's Registration Statement on Form SB-2, File No. 333-5240-NY,
filed with the Securities and Exchange Commission on July 5, 1996, a
copy which incorporated information is attached hereto as Exhibit A.
Item 2. Exhibits.
Exhibit
Number Description of Document
A The "Description of Securities" section of the Preliminary
Prospectus forming a part of the Registrant's Registration
Statement on Form SB-2, File No. 333-5240-NY, is incorporated
herein by reference as referred to in Item 1.
1.1 Form of Common Stock Certificate.
2.1 Restated Certificate of Incorporation (filed as Exhibit 3.1 to
the Registration Statement of the Registrant on Form SB-2, File
No. 333-5240-NY, and hereby incorporated herein by reference).
2.2 By-Laws (filed as Exhibit 3.2 to the Registration Statement of
the Registrant on Form SB-2, File No. 333-5240-NY, and hereby
incorporated herein by reference).
2.3 Form of Warrant Agreement governing the Class A Redeemable
Warrants (filed as Exhibit 4.1 to the Registration Statement of
the Registrant on Form SB-2, File No. 333-5240-NY, and hereby
incorporated herein by reference).
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SIGNATURE
Pursuant to the requirements of Section 12 of the Securities Act of
1934, the Registrant has duly caused this registration statement to be signed on
its behalf by the undersigned, thereunto duly authorized.
CHEM INTERNATIONAL, INC.
________________________
Registrant
By: /s/ E. Gerald Kay
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E. Gerald Kay, President
DATE: July 22, 1996
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NUMBER SHARES
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CHEM INTERNATIONAL, INC.
INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
SEE REVERSE FOR
CERTAIN DEFINITIONS
CUSIP 163527 20 3
THIS CERTIFIES THAT
IS THE OWNER OF
FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK OF PAR
VALUE $.002 PER SHARE
CHEM INTERNATIONAL, INC.
(herein called the "Corporation"), transferable only on the books of the
Corporation by the holder hereof in person or by duly authorized attorney
upon the surrender of this Certificate properly endorsed or assigned for
transfer. This Certificate is not valid until countersigned by the Transfer
Agent and registered by the Registrar.
WITNESS the facsimile seal of the Corporation and the facsimile signatures
of its duly authorized officers.
CERTIFICATE OF STOCK
Dated:
SECRETARY CHEM INTERNATIONAL, INC. PRESIDENT
CORPORATE
SEAL
1995
DELAWARE
COUNTERSIGNED AND REGISTERED:
CONTINENTAL STOCK TRANSFER &
TRUST COMPANY
(New York) Transfer Agent and Registrar
BY:
AUTHORIZED OFFICER
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CHEM INTERNATIONAL, INC.
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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 or regulations:
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<S> <C> <C>
TEN COM- as tenants in common UNIF GIFT MIN ACT-_____________Custodian___________
TEN ENT- as tenants by the (Cust) (Minor)
entireties under Uniform Gifts to Minors
JT TEN- as joint tenants with Act__________________________
right of survivorship and (State)
not as tenants in common
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, OR ASSIGNEE)
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________________________________________________________ Shares of the capital
stock represented by the written Certificate, and do hereby irrevocably
constitute and appoint _________________________________________________________
_________________________________________________________ Attorney, to transfer
the said stock on the books of the written named Corporation with full power of
substitution in the premises.
Dated, ____________________________
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NOTICE: THE SIGNATURE(S) TO THIS
ASSIGNMENT MUST CORRESPOND WITH THE
NAME(S) AS WRITTEN UPON THE FACE OF
THE CERTIFICATE, IN EVERY
PARTICULAR, WITHOUT ALTERNATION OR
ENLARGEMENT OR ANY CHANGE
WHATSOEVER.
SIGNATURE GUARANTEED:--------------------------------------------
THE SIGNATURE(S) SHOULD BE
GUARANTEED BY AN ELIGIBLE GUARANTOR
INSTITUTION, (BANKS, STOCKBROKERS,
SAVINGS AND LOAN ASSOCIATIONS AND
CREDIT UNIONS WITH MEMBERSHIP IN AN
APPROVED SIGNATURE GUARANTEE
MEDALLION PROGRAM), PURSUANT TO
S.E.C. RULE 17AD-15.
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