-----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, Dx+yR+iB/m/4pXiM1LHog96UuYBv6nKJj9xj0cFgv4cC12L/OzkusxeC3MD8DoAu XQceSeRvuNzNt+YYSMVE/g== 0000909654-04-001716.txt : 20040615 0000909654-04-001716.hdr.sgml : 20040615 20040615151550 ACCESSION NUMBER: 0000909654-04-001716 CONFORMED SUBMISSION TYPE: 8-A12G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040615 FILER: COMPANY DATA: COMPANY CONFORMED NAME: SI Financial Group, Inc. CENTRAL INDEX KEY: 0001292580 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 000000000 STATE OF INCORPORATION: X1 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-A12G SEC ACT: 1934 Act SEC FILE NUMBER: 000-50801 FILM NUMBER: 04864132 BUSINESS ADDRESS: STREET 1: 803 MAIN STREET CITY: WILLIMANTIC STATE: CT ZIP: 06226 BUSINESS PHONE: (860) 423-4581 MAIL ADDRESS: STREET 1: 803 MAIN STREET CITY: WILLIMANTIC STATE: CT ZIP: 06226 8-A12G 1 sifinancialform8a6-04.txt 1 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 SI FINANCIAL GROUP, INC. ------------------------ (Exact name of registrant as specified in its charter) UNITED STATES Applied For - ---------------- ------------ (state of incorporation or organization) (I.R.S. Employer Identification No.) 803 Main Street, Willimantic, Connecticut 06226 - ------------------------------------------- ---------- (Address of principal executive offices) (Zip Code) Securities to be registered pursuant to Section 12(b) of the Act: None If this form relates to the registration of a class of securities pursuant to Section 12(b) of the Exchange Act and is effective pursuant to General Instruction A.(c), check the following box. [ ] If this form relates to the registration of a class of securities pursuant to Section 12(g) of the Exchange Act and is effective pursuant to General Instruction A.(d), check the following box. [ X ] Securities Act registration statement file number to which this form relates: 333-116381. Securities to be registered pursuant to Section 12(g) of the Act: COMMON STOCK, PAR VALUE $.01 PER SHARE -------------------------------------- (Title of class) 2 ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED. Incorporated by reference to the portion of the Prospectus under the heading: "Description of SI Financial Group Capital Stock," filed on June 10, 2004 as part of the Registrant's Registration Statement on Form S-1, No. 333-116381. ITEM 2. EXHIBITS. 1. Copies of all constituent instruments defining the rights of all the holders of each class of such securities, including any contracts or other documents which limit or qualify the rights of such holders. (a) Charter Incorporated by reference to Exhibit 3.1 to Registrant's Registration Statement on Form S-1, No. 333-116381, filed on June 10, 2004. (b) Bylaws Incorporated by reference to Exhibit 3.2 to Registrant's Registration Statement on Form S-1, No. 333-116381, filed on June 10, 2004. (c) Plan of Reorganization and Minority Stock Issuance Incorporated by reference to Exhibit 2.1 to Registrant's Registration Statement on Form S-1, No. 333-116381, filed on June 10, 2004. 2. A copy of the security to be registered hereunder is incorporated by reference to Exhibit 4.1 to Registrant's Registration Statement on Form S-1, No. 333-116381, filed on June 10, 2004. 3 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. SI FINANCIAL GROUP, INC. ------------------------ (Registrant) Date: June 14, 2004 By: /s/ Rheo A. Brouillard ------------------------------------------- Rheo A. Brouillard President and Chief Executive Officer -----END PRIVACY-ENHANCED MESSAGE-----