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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 12(g) OF THE
SECURITIES EXCHANGE ACT OF 1934
SUMMIT HOLDING SOUTHEAST, INC.
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(Exact Name of Registrant as Specified in Its Charter)
Florida 59-3409855
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(State of Incorporation or (I.R.S. Employer Identification
Organization) No.)
2310 A-Z Park Road, Lakeland, Florida 33801
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(Address of Principal Executive (Zip Code)
Offices)
If this form relates to the If this form relates to the
registration of a class of debt registration of a class of debt
securities and is effective securities and is to become effective
upon filing pursuant to simultaneously with the effectiveness
General Instruction A(c)(1) of a concurrent registration statement
please check the following box. 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:
Title to Each Class Name of Each Exchange on Which
to be so Registered Each Class is to be Registered
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None
Securities to be registered pursuant to Section 12(g) of the Act:
Common Stock, par value $0.01 per share
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(Title of Class)
Series A Preferred Stock, par value $10.00 per share
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(Title of Class)
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ITEM 1. DESCRIPTION OF SECURITIES TO BE REGISTERED.
The description of the Registrant's Common Stock and Series A Preferred
Stock registered hereby is incorporated by reference to "Description of Capital
Stock" in the Registrant's Form S-1 Registration Statement No. 333-16499, as
filed with the Securities and Exchange Commission on November 20, 1996, as
amended on December 9, 1996, January 8, 1997, January 27, 1997, February 21,
1997, March 13, 1997, April 4, 1997 and April 15, 1997 and any amendments to
such Registration Statement filed subsequently hereto, including any form of
Prospectus filed pursuant to Rule 424(b) under the Securities Act of 1933, as
amended.
ITEM 2. EXHIBITS.
1. Articles of Incorporation of the Registrant (incorporated herein
by reference to Exhibit 3.1 to the Registrant's Form S-1 Registration Statement
No. 333-16499 (the "Form S-1")).
2. Form of Certificate of Designation, Preferences and Rights of
Series A Preferred Stock of the Registrant (incorporated herein by reference to
Exhibit 3.3 to the Form S-1).
3. Bylaws of the Registrant (incorporated herein by reference to
Exhibit 3.2 to the Form S-1).
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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, thereunto duly authorized.
SUMMIT HOLDING SOUTHEAST, INC.
/s/ William B. Bull
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William B. Bull
President and Chief Executive Officer
Date: April 23, 1997
