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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
AMERUS LIFE HOLDINGS, INC.
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(Exact name of registrant as specified in its charter)
IOWA 42-1459712
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(State of incorporation (I.R.S. Employer
or organization) Identification No.)
418 Sixth Avenue, Des Moines, Iowa 50306-2499
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(Address of principal executive offices) (Zip Code)
If this Form relates to If this Form relates to
the registration of a the registration of a class
class of debt securities of debt securities and is to
and is effective upon become effective
filing pursuant to General simultaneously with the
Instruction A(c)(1) please effectiveness of a concurrent
check the following box. [ ] 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(b) of the Act:
None
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Securities to be registered pursuant to Section 12(g) of the Act:
Class A Common Stock, no par value
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(Title of Class)
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ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED
The description (the "Description") of the Registrant's Class A Common
Stock, no par value, appearing under the caption "Description of the Capital
Stock" in the Registrant's Preliminary Prospectus, dated September 18, 1996,
included in its Registration Statement on Form S-1 (File No. 333-12239), is
incorporated herein by reference. Any subsequent amendment or any report filed
for the purpose of updating the Description, and any description of the Class A
Common Stock appearing under the caption "Description of the Capital Stock" in
the Prospectus to be filed pursuant to Rule 424(b) under the Securities Act,
relating to Registration Statement No. 333-12239, are deemed to be incorporated
herein by reference.
There is no established public trading market for the Class A Common
Stock. Application has been made for quotation of the Class A Common Stock on
the Nasdaq National Market.
ITEM 2. EXHIBITS
Exhibit No. Description
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1 The Registrant's Articles of Incorporation are hereby
incorporated by reference to Exhibit 3.1 to the Registrant's
Registration Statement on Form S-1, as amended (File No.
333-12239).
2 The Registrant's Bylaws are hereby incorporated by reference to
Exhibit 3.2 to the Registrant's Registration Statement on Form
S-1, as amended (File No. 333-12239).
3 The Registrant's Proposed Amended and Restated Articles of
Incorporation are hereby incorporated by reference to Exhibit 3.3
to the Registrant's Registration Statement on Form S-1, as
amended (File No. 333-12239).
4 The Registrant's Form of Certificate for shares of Class A Common
stock will be filed by amendment.
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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.
Date: October 1, 1996
AMERUS LIFE HOLDINGS, INC.
By: /s/ Roger K. Brooks
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Roger K. Brooks
Chairman, President and
Chief Executive Officer
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EXHIBIT INDEX
Exhibit No. Description
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1 The Registrant's Articles of Incorporation are hereby
incorporated by reference to Exhibit 3.1 to the Registrant's
Registration Statement on Form S-1, as amended (File No.
333-12239).
2 The Registrant's Restated Bylaws are hereby incorporated by
reference to Exhibit 3.2 to the Registrant's Registration
Statement on Form S-1, as amended (File No. 333-12239).
3 The Registrant's Proposed Amended and Restated Articles of
Incorporation are hereby incorporated by reference to Exhibit 3.3
to the Registrant's Registration Statement on Form S-1, as
amended (File No. 333-12239).
4 The Registrant's Form of Certificate for shares of Class A Common
Stock will be filed by amendment.
