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FORM 8-A
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(b) OR (g) OF THE
SECURITIES EXCHANGE ACT OF 1934
ASSISTED LIVING CONCEPTS, INC.
(Exact name of registrant as specified in its charter)
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<S> <C>
Nevada 93-1148702
(State of incorporation or organization) (I.R.S. Employer Identification No.)
9955 S.E. Washington, Suite 201 97216
Portland, Oregon (Zip Code)
(Address of principal executive offices)
If this form relates to the registration of a If this form relates to the registration of a
class of securities pursuant to Section 12(b) class of securities pursuant to Section 12(g)
of the Exchange Act and is effective pursuant of the Exchange Act and is effective pursuant
to General Instruction A.(c), check the to General Instruction A.(d), check the
following box. [X] following box. [_]
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SECURITIES TO BE REGISTERED PURSUANT TO
SECTION 12(b) OF THE ACT:
5.625% Convertible Subordinated Debentures Due 2003
(Title of each class to be registered)
American Stock Exchange
(Name of each exchange on which each class is to be registered)
SECURITIES TO BE REGISTERED PURSUANT TO
SECTION 12(g) OF THE ACT:
None
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ITEM 1. Description of Registrant's Securities to be Registered.
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A Description of the 5.625% Convertible Subordinated Debentures Due
2003 (the "Debentures") to be registered hereunder is contained in the section
entitled "Description of Debentures" on pages 13 through 20 of the Prospectus
included in the Registrant's Form S-3 Registration Statement, No. 333-52297, as
filed with the Securities and Exchange Commission (the "Commission") on May 11,
1998, as amended by Amendment No. 1 filed with the Commission on July 22, 1998.
Such description is incorporated herein by reference.
ITEM 2. Exhibits.
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Exhibit
Number Description
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1.1 Form of Indenture relating to the Debentures. (1)
1.2 Form of Debenture. (2)
2.1 Articles of Incorporation of Registrant. (3)
2.2 Bylaws of Registrant. (4)
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(1) Filed as exhibit number 4.1 to the Registrant's Form S-3
Registration Statement No. 333-52297, and incorporated herein by
reference.
(2) Filed as exhibit number 4.3 to the Registrant's Form S-1
Registration Statement No.333-52297, and incorporated herein by
reference.
(3) Filed as exhibit number 3.1 to the Registrant's Form S-1
Registration Statement No. 33-83938, and incorporated herein by
reference.
(4) Filed as exhibit number 3.2 to the Registrant's Form S-1
Registration Statement No. 33-83938, and incorporated herein by
reference.
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SIGNATURE
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Pursuant to the requirements of Section 12 of the Securities Exchange Act of
1934, as amended, the Registrant has duly caused this Registration Statement to
be signed on its behalf by the undersigned, thereto duly authorized.
July 22, 1998 Assisted Living Concepts, Inc.
("Registrant")
By: /s/ Rhonda S. Marsh
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Rhonda S. Marsh
Vice President and
Chief Accounting Officer
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