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UNITED STATES
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
BEVERLY BANCORPORATION, INC.
(Exact name of Registrant as specified in its charter)
Delaware 36-4090152
(State of incorporation or organization) (I.R.S. Employer
Identification No.)
1357 W. 103rd Street
Chicago, Illinois 60643
(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:
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, par value $.01 per share
(Title of class)
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Information Required In Registration Statement
ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED.
A description of the Registrant's Common Stock to be registered
hereby will be included under the section entitled "Description of
Capital Stock" of the Prospectus to be filed by the Registrant
pursuant to Rule 424(b) under the Securities Act of 1933 relating to
the Registrant's Registration Statement on Form S-1, No. 333-6651.
Such Prospectus is incorporated herein by reference.
ITEM 2. EXHIBITS.
No. Document
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1 Form of certificate for shares of Common Stock of the
Registrant, which is incorporated herein by reference to
Exhibit 4(a) to the Registrant's Registration Statement on
Form S-1, No. 333-6651.
2 Certificate of Incorporation of the Registrant, which is
incorporated herein by reference to Exhibit 3(a) to the
Registrant's Registration Statement on Form S-1, No. 333-
6651.
3 By-Laws of the Registrant, which is incorporated herein by
reference to Exhibit 3(b) to the Registrant's Registration
Statement on Form S-1, No. 333-6651.
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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, this 29th day of
July, 1996.
BEVERLY BANCORPORATION, INC.
By: /s/ John D. Van Winkle
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John D. Van Winkle
President and
Chief Executive Officer
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