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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
AMERICAN PHYSICIANS CAPITAL, INC.
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(Exact name of registrant as specified in its charter)
MICHIGAN 38-3543910
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(State of incorporation or organization (I.R.S. employer
identification number)
1301 N. HAGADORN ROAD, EAST LANSING, MI 48823
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(Address of principal executive offices) (Zip Code)
If this form relates to the registration of a class of securities pursuant to
Section 12(b) of the Exchange Act and is effective pursuant to General
Instruction A.(c), please check the following box: / /
If this form relates to the registration of a class of securities pursuant to
Section 12(g) of the Exchange Act and is effective pursuant to General
Instruction A.(d), please check the following box: /X/
Securities Act registration statement file number to which this form relates:
No. 333-41136.
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 None
Securities to be registered pursuant to Section 12(g) of the Act:
Common Stock (no par value) NASDAQ National Market
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ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED.
The description of the Registrant's Common Stock, set forth under
the caption "Description of Securities" in the Registrant's Registration
Statement on Form S-1 (No. 333-41136) (the "Registration Statement"), is
incorporated herein by reference.
ITEM 2. EXHIBITS.
Copies of all constituent instruments defining the rights of the holders of each
class of such securities:
(a) Articles of Incorporation
Incorporated by reference to Exhibit 3.1 to registrant's
registration statement on Form S-1, No. 333-41136, filed on July
11, 2000.
(b) Bylaws
Incorporated by reference to Exhibit 3.2 to registrant's
registration statement on Form S-1, No. 333-41136, filed on July
11, 2000.
(c) Plan of Conversion
Incorporated by reference to Exhibit 2.1 to registrant's
registration statement on Form S-1, No. 333-41136, filed on July
11, 2000.
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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: December 5, 2000 AMERICAN PHYSICIANS CAPITAL, INC.
By: /s/ William B. Cheeseman
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William B. Cheeseman
Its: President and Chief Executive Officer
