-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, GCPRR4pN5Mwj97u8K3v08SnDDaQzBcAtpMekuE+sN8VMGXkQ3xrWEEpLR9z7ZbbU ojbJRGM3h0MhMqQYHypDyw== 0000950117-96-001495.txt : 19961122 0000950117-96-001495.hdr.sgml : 19961122 ACCESSION NUMBER: 0000950117-96-001495 CONFORMED SUBMISSION TYPE: 8-A12G CONFIRMING COPY: PUBLIC DOCUMENT COUNT: 2 FILED AS OF DATE: 19961121 SROS: NASD FILER: COMPANY DATA: COMPANY CONFORMED NAME: CHEM INTERNATIONAL INC CENTRAL INDEX KEY: 0001016504 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 133035216 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-A12G SEC ACT: 1934 Act SEC FILE NUMBER: 000-28876 FILM NUMBER: 00000000 BUSINESS ADDRESS: STREET 1: 201 ROUTE 22 CITY: HILLSIDE STATE: NJ ZIP: 07205 BUSINESS PHONE: 2019260816 MAIL ADDRESS: STREET 1: 201 ROUTE 223 CITY: HILLSIDE STATE: NJ ZIP: 07205 8-A12G 1 CHEM INTERNATIONAL, INC. 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 CHEM INTERNATIONAL, INC. - -------------------------------------------------------------------------------- (Exact name of registrant as specified in its charter) DELAWARE 13-3035216 - -------------------------------------------------------------------------------- (State of incorporation or organization) (IRS Employee Identification #) 201 Route 22, Hillside, New Jersey 07205 - -------------------------------------------------------------------------------- (Address of principal executive offices) (Zip Code) 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 ___________________ ______________________________ NONE NONE ___________________ ______________________________ ___________________ ______________________________ If this Form relates to the registration of a class of debt securities and is to become effective upon filing pursuant to General Instruction A.(c)(1), check the following box: [ ] If this Form relates to the registration of a class of debt securities and is to become effective simultaneously with effectiveness of a concurrent registration statement under the Securities Act of 1933 pursuant to General Instruction A.(c)(2), check the following box: [ ] Securities to be registered pursuant to Section 12(g) of the Act: COMMON STOCK, PAR VALUE $.002 PER SHARE - -------------------------------------------------------------------------------- (Title of Class) CLASS "A" REDEEMABLE COMMON STOCK PURCHASE WARRANTS - -------------------------------------------------------------------------------- (Title of Class) Item 1. Description of Registrant's Securities to be Registered. A description of the Registrant's securities to be registered is incorporated herein by reference to the section entitled "Description of Securities" in the Preliminary Prospectus forming a part of the Registrant's Registration Statement on Form SB-2, File No. 333-5240-NY, filed with the Securities and Exchange Commission on July 5, 1996, a copy which incorporated information is attached hereto as Exhibit A. Item 2. Exhibits. Exhibit Number Description of Document A The "Description of Securities" section of the Preliminary Prospectus forming a part of the Registrant's Registration Statement on Form SB-2, File No. 333-5240-NY, is incorporated herein by reference as referred to in Item 1. 1.1 Form of Common Stock Certificate. 2.1 Restated Certificate of Incorporation (filed as Exhibit 3.1 to the Registration Statement of the Registrant on Form SB-2, File No. 333-5240-NY, and hereby incorporated herein by reference). 2.2 By-Laws (filed as Exhibit 3.2 to the Registration Statement of the Registrant on Form SB-2, File No. 333-5240-NY, and hereby incorporated herein by reference). 2.3 Form of Warrant Agreement governing the Class A Redeemable Warrants (filed as Exhibit 4.1 to the Registration Statement of the Registrant on Form SB-2, File No. 333-5240-NY, and hereby incorporated herein by reference). SIGNATURE Pursuant to the requirements of Section 12 of the Securities Act of 1934, the Registrant has duly caused this registration statement to be signed on its behalf by the undersigned, thereunto duly authorized. CHEM INTERNATIONAL, INC. ________________________ Registrant By: /s/ E. Gerald Kay -------------------------- E. Gerald Kay, President DATE: July 22, 1996 EX-1 2 EXHIBIT 1.1 NUMBER SHARES ------ ------ CHEM INTERNATIONAL, INC. INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE SEE REVERSE FOR CERTAIN DEFINITIONS CUSIP 163527 20 3 THIS CERTIFIES THAT IS THE OWNER OF FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK OF PAR VALUE $.002 PER SHARE CHEM INTERNATIONAL, INC. (herein called the "Corporation"), transferable only on the books of the Corporation by the holder hereof in person or by duly authorized attorney upon the surrender of this Certificate properly endorsed or assigned for transfer. This Certificate is not valid until countersigned by the Transfer Agent and registered by the Registrar. WITNESS the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers. CERTIFICATE OF STOCK Dated: SECRETARY CHEM INTERNATIONAL, INC. PRESIDENT CORPORATE SEAL 1995 DELAWARE COUNTERSIGNED AND REGISTERED: CONTINENTAL STOCK TRANSFER & TRUST COMPANY (New York) Transfer Agent and Registrar BY: AUTHORIZED OFFICER CHEM INTERNATIONAL, INC. - -------------------------------------------------------------------------------- The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws or regulations: TEN COM- as tenants in common UNIF GIFT MIN ACT-_____________Custodian___________ TEN ENT- as tenants by the (Cust) (Minor) entireties under Uniform Gifts to Minors JT TEN- as joint tenants with Act__________________________ right of survivorship and (State) not as tenants in common Additional abbreviations may also be used though not in the above list. For Value received______________________________________hereby sell, assign and transfer unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OR ASSIGNEE) - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- ________________________________________________________ Shares of the capital stock represented by the written Certificate, and do hereby irrevocably constitute and appoint _________________________________________________________ _________________________________________________________ Attorney, to transfer the said stock on the books of the written named Corporation with full power of substitution in the premises. Dated, ____________________________ X----------------------------------- X----------------------------------- NOTICE: THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME(S) AS WRITTEN UPON THE FACE OF THE CERTIFICATE, IN EVERY PARTICULAR, WITHOUT ALTERNATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER. SIGNATURE GUARANTEED:-------------------------------------------- THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION, (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17AD-15.
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