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SECURITIES AND EXCHANGE COMMISSION
Washington, DC 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
INSPIRE INSURANCE SOLUTIONS, INC.
(Exact Name of Registrant as Specified in Its Charter)
TEXAS 75-2595937
(State of Incorporation or Organization) (I.R.S. Employer Identification No.)
300 BURNETT STREET, FORT WORTH, TEXAS 76102-2799
(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
following 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
Instruction A(c)(2), please check the following box [ ]
Securities to be registered pursuant to Section 12(b) of the Act:
NONE
Securities to be registered pursuant to Section 12(g) of the Act:
COMMON STOCK, $.01 PAR VALUE PER SHARE,
SERIES A JUNIOR PREFERRED STOCK PURCHASE RIGHTS
(Title of Classes)
ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED.
The material set forth in the section captioned "Description of Capital Stock"
in the Registrant's Registration Statement on Form S-1 (Registration No.
333-31173), filed with the Securities and Exchange Commission on July 11, 1997,
as amended, is incorporated herein by reference.
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ITEM 2. EXHIBITS.
Exhibit No. Description
1 Restated Articles of Incorporation of INSpire Insurance
Solutions, Inc. (the "Company") (filed as Exhibit 3.1 to the
Registrant's Registration Statement on Form S-1 (Registration
No. 333-31173), filed on July 11, 1997 (the "Registration
Statement")) and Articles of Amendment No. 1 thereto (filed as
Exhibit 3.1 to Amendment No. 1 to the Registration Statement
filed on July 30, 1997 ("Amendment No. 1") and incorporated
herein by reference).
2 Amended and Restated Bylaws of the Company (filed as Exhibit 3.2
to Amendment No. 1 and incorporated herein by reference).
3 Specimen Certificate for shares of common stock, $.01 par value,
of the Company (filed as Exhibit 4.1 to Amendment No. 2 to the
Registration Statement filed on August 21, 1997 and incorporated
herein by reference).
4 Rights Agreement, by and between the Company and U.S. Trust
Company of Texas, N.A., dated as of July 30, 1997 (filed as
Exhibit 4.2 to Amendment No. 1 and incorporated herein by
reference).
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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.
INSPIRE INSURANCE SOLUTIONS, INC.
Date: August 21, 1997 By: /s/ F. GEORGE DUNHAM, III
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F. George Dunham, III
President and Chief Executive Officer
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