-----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, LcntfGZWUT8M2Rp1TpEjFC5Tg0SHOlAoUJyrFnoqjHNDGTFh+1ApHk5GI5DCQJlu /i6UwtoAiqWPLl3PFSrdvw== 0000950172-05-002197.txt : 20050712 0000950172-05-002197.hdr.sgml : 20050712 20050712151413 ACCESSION NUMBER: 0000950172-05-002197 CONFORMED SUBMISSION TYPE: 8-A12B/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20050712 DATE AS OF CHANGE: 20050712 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PACIFICARE HEALTH SYSTEMS INC /DE/ CENTRAL INDEX KEY: 0001027974 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 954591529 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-A12B/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-31700 FILM NUMBER: 05950299 BUSINESS ADDRESS: STREET 1: 5995 PLAZA DRIVE CITY: CYPRESS STATE: CA ZIP: 90630-5028 BUSINESS PHONE: 714-952-1121 MAIL ADDRESS: STREET 1: 5995 PLAZA DRIVE CITY: CYPRESS STATE: CA ZIP: 90630-5028 FORMER COMPANY: FORMER CONFORMED NAME: N T HOLDINGS INC DATE OF NAME CHANGE: 19961204 8-A12B/A 1 ny596999.txt REGISTRATION OF SECURITIES PURSUANT TO '34 ACT UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 ----------------- FORM 8-A/A FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES Pursuant to Section 12(b) OR 12(g) of the Securities Exchange Act of 1934 PacifiCare Health Systems, Inc. (Exact Name of Registrant as Specified in its Charter) Delaware 001-31700 95-4591529 (State or Other Jurisdiction (Commission File (IRS Employer of Incorporation) Number) Identification No.) 5995 Plaza Dr. Cyprus, California 90630-5028 (Address of Principal Executive Offices) (Zip Code) (714) 952-1121 (Registrant's telephone number, including area code) If this form relates to the If this form relates to the registration of a class securities registration of a class of pursuant to Section of 12(b) of the securities pursuant to Section Exchange Act and is effective 12(g) of the Exchange Act and is pursuant to General Instruction effective pursuant to General A.(c), please check the following Instruction A.(d), please check box. /X/ the following box. / / Securities Act registration statement file number to which this form relates: N/A Securities to be registered pursuant to Section 12(b) of the Act:
Name of Each Exchange on Which Each Class Title of Each Class to be so Registered is to be Registered - ----------------------------------------------------- ----------------------------------------------------- Preferred Share Purchase Rights New York Stock Exchange
Securities to be registered pursuant to Section 12(g) of the Act: None. ----------------- Title of Class We hereby amend the following items, exhibits or other portions of our Form 8-A filed on December 3, 2001 related to our Preferred Share Purchase Rights, as set forth below. Item 1. Description of Registrant's Securities to be Registered. Item 1 of Registrant's Form 8-A is hereby amended by restating in its entirety the second sentence of Item 1 therein with the following: "A description of the rights to purchase Series A junior participating preferred stock registered hereunder is contained in the Registrant's Form 8-K and the exhibits thereto filed with the Commission on November 19, 1999 and incorporated by reference herein and in the Registrant's Form 8-K and the exhibits thereto filed with the Commission on July 12, 2005 and incorporated by reference herein." 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. PACIFICARE HEALTH SYSTEMS, INC. By: /s/ Peter Reynolds ----------------------------------- Name: Peter Reynolds Title: Senior Vice President, Finance; Corporate Controller Date: July 12, 2005
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