-----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, Go5gWrhXQkiKxrIVa39aHnQIjPbyTwAVeyDZroulwac9snjmrhBPyvtfe8Mhn5Qd uWAs7sZueeKiNKqUpMnc6w== 0000898080-96-000121.txt : 19960820 0000898080-96-000121.hdr.sgml : 19960820 ACCESSION NUMBER: 0000898080-96-000121 CONFORMED SUBMISSION TYPE: 8-A12B PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19960819 SROS: NASD FILER: COMPANY DATA: COMPANY CONFORMED NAME: CHARTWELL RE CORP CENTRAL INDEX KEY: 0000912047 STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321] IRS NUMBER: 411652573 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-A12B SEC ACT: 1934 Act SEC FILE NUMBER: 001-12502 FILM NUMBER: 96617791 BUSINESS ADDRESS: STREET 1: 300 ATLANTIC ST STREET 2: STE 400 CITY: STAMFORD STATE: CT ZIP: 06901 BUSINESS PHONE: 2039617300 MAIL ADDRESS: STREET 1: 300 ATLANTIC ST STREET 2: STE 400 CITY: STAMFORD STATE: CT ZIP: 06901-3540 8-A12B 1 FORM 8-A SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ________ FORM 8-A FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES PURSUANT TO SECTION 12(b) OR 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934 CHARTWELL RE CORPORATION ________________________ (Exact Name of Issuer as Specified in its Charter) Delaware 41-1652573 ________ __________ (State of Incorporation (I.R.S. Employer or Organization) Identification no.) 300 Atlantic Street, Suite 400 Stamford, Connecticut 06901 ______________________ _____ (Address of Issuer's principal (zip code) executive offices) If this Form relates to the If this Form relates to the registration of a class of debt registration of a class of securities and is effective debt securities and is to upon filing pursuant to General become effective Instruction A(c)(1) please simultaneously with the check the following box. _____ effectiveness of a concurrent registration statement under the Securities Act of 1933 pursuant to General Instruction A(c)(2) please check the following box. _____ 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 Common Stock, par value $.01 New York Stock Exchange, Inc. Securities to be registered pursuant to Section 12(g) of the Act: None Item 1. Description of Securities to be Registered. Chartwell Re Corporation, a corporation organized under the laws of the State of Delaware (the "Issuer"), is applying for registration of its Common Stock, par value $.01 per share (the "Common Stock") under Section 12(b) of the Act. The description of the Common Stock is set forth under the caption "Description of Capital Stock" contained in the Registration Statement on Form S-1 (File No. 333-678) filed on January 26, 1996, with the Securities and Exchange Commission under the Securities Act of 1933, as amended (the "Act"), as amended by Amendments Nos. 1, 2 and 3, and is incorporated herein by reference. Item 2. Exhibits. The Common Stock is to be registered on the New York Stock Exchange, Inc. Pursuant to Instruction II as to exhibits, the following exhibits are included with each copy of this Registration Statement to be filed with the New York Stock Exchange, Inc.: Exhibit Number Exhibit 1(a) 1995 Annual Report of the Issuer 1(b) 10-Q of the Issuer for the period ended March 31, 1996 1(c) 10-Q of the Issuer for the period ended June 30, 1996 1(d) Proxy Statement of the Issuer, dated April 12, 1996 1(e) Restated Certificate of Incorporation of the Issuer 1(f) Amended and Restated Bylaws of the Issuer 1(g) Stockholders Agreement 1(h) Registration Rights Agreement 1(i) Form of Stock Certificate SIGNATURES Pursuant to the requirements of Section 12 of the Securities Exchange Act of 1934, the Issuer has duly caused this registration statement to be signed on its behalf by the undersigned, thereto duly authorized. CHARTWELL RE CORPORATION By: /s/ Kathleen M. Carroll _______________________________ Vice President, General Counsel and Secretary Dated: August 19, 1996 EXHIBIT INDEX Exhibit Number Exhibit 1(a) 1995 Annual Report of the Issuer 1(b) 10-Q of the Issuer for the period ended March 31, 1996 1(c) 10-Q of the Issuer for the period ended June 30, 1996 1(d) Proxy Statement of the Issuer, dated April 12, 1996 1(e) Restated Certificate of Incorporation of the Issuer 1(f) Amended and Restated Bylaws of the Issuer 1(g) Stockholders Agreement 1(h) Registration Rights Agreement 1(i) Form of Stock Certificate -----END PRIVACY-ENHANCED MESSAGE-----