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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
CENTENNIAL HEALTHCARE CORPORATION
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(Exact name of registrant as specified in its charter)
Georgia 58-1839701
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(State of incorporation (IRS Employer Identification No.)
or organization)
400 Perimeter Center Terrace, Suite 650, Atlanta, GA 30346
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(Address of principal executive offices) (Zip Code)
If this form relates to the If this form relates to the
registration of a class of debt registration of a class of
securities and is effective debt securities and is to
upon filing pursuant to become effective
General Instruction A(c)(1) please simultaneously with the
check the following box. / / 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(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 ___________________________
Securities to be registered pursuant to Section 12(g) of the Act:
Common Stock, $0.01 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 of the common stock, $.01 par value, of Centennial
HealthCare Corporation (the "Company") appearing under the heading "Description
of Capital Stock" in the Prospectus included in the Company's Registration
Statement on Form S-1 (Registration No. 333-24267) is incorporated herein by
reference.
Item 2. Exhibits.
2.1 Third Amended and Restated Articles of Incorporation (incorporated by
reference to Exhibit 3.1 of Registration Statement on Form S-1,
Registration No. 333-24267).
2.2 Amended and Restated Bylaws (incorporated by reference to Exhibit 3.2 of
Registration Statement on Form S-1, Registration No. 333-24267).
2.3 See Exhibits 2.1 and 2.2 for provisions of the Third Amended and Restated
Articles of Incorporation and Amended and Restated Bylaws defining the
rights of holders of the Common Stock (incorporated by reference to
Exhibits 3.1 and 3.2 of the Registration Statement on Form S-1,
Registration No. 333-24267).
2.4 Specimen stock certificate (incorporated by reference to Exhibit 4.3 of the
Registration Statement on Form S-1, Registration No. 333-24267).
2
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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.
CENTENNIAL HEALTHCARE, INC.
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(Registrant)
By: /s/ Kent C. Fosha, Sr.
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Kent C. Fosha, Sr.
Executive Vice President
Of Operations
Date: June 27, 1997
