8-A12B/A 1 ny1020627.txt FORM 8A AMENDMENT 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. Cypress, 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 registration of a class If this form relates to the registration of a class securities pursuant to Section 12(b) of the Exchange of securities pursuant to Section 12(g) of the Act and is effective pursuant to General Instruction A.(c), Exchange Act and is effective pursuant to General please check the following box. /X/ Instruction A.(d), please check 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 Title of Each Class to be so Registered Each Class 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 May 30, 2003 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: The Registrant hereby incorporates by reference (i) the description of its securities to be registered hereunder contained in the Prospectus, dated February 12, 2003, under "Description of Capital Stock" filed with the Securities and Exchange Commission on February 12, 2003 under Rule 424(b) of the Securities Act of 1933, as amended, pursuant to an effective Registration Statement on Form S-3 (File No. 333-102909) filed with the Securities and Exchange Commission on January 31, 2003 and (ii) the Registrant's Form 8-K and the exhibits filed thereto with the Commission on July 12, 2005, disclosing the amendment of the Registrant's Rights Agreement, dated as of November 19, 1999. 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/ Joseph Konowiecki --------------------- Name: Joseph Konowiecki Title: Executive Vice President and General Counsel Date: August 2, 2005