-----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, E+nIg0LgvGG+4RFoJUa9nNmsGgvuz8isAxhwGq/PFj8KekqFgI9uStdt3EBkhPjY nyxCZEE5wAvKO1x9ChWaAw== 0000950147-96-000492.txt : 19961031 0000950147-96-000492.hdr.sgml : 19961031 ACCESSION NUMBER: 0000950147-96-000492 CONFORMED SUBMISSION TYPE: 8-A12G PUBLIC DOCUMENT COUNT: 2 FILED AS OF DATE: 19961030 SROS: NASD FILER: COMPANY DATA: COMPANY CONFORMED NAME: MD LABS INC CENTRAL INDEX KEY: 0001015438 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS FOOD PREPARATIONS & KINDRED PRODUCTS [2090] IRS NUMBER: 860753257 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-A12G SEC ACT: 1934 Act SEC FILE NUMBER: 000-21651 FILM NUMBER: 96650412 BUSINESS ADDRESS: STREET 1: 1719 W UNIVERSITY STREET 2: SUITE 187 CITY: TEMPE STATE: AZ ZIP: 85281 BUSINESS PHONE: 6024370127 MAIL ADDRESS: STREET 1: 1719 WEST UNIVERSITY DR STREET 2: STE 187 CITY: TEMPE STATE: AZ ZIP: 85281 8-A12G 1 FORM 8-A ================================================================================ SECURITIES AND EXCHANGE COMMISSION 450 Fifth Street, N.W., 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 -------- M.D. Labs, Inc. (Exact name of registrant as specified in its charter) Delaware 86-0835247 (State or other jurisdiction (I.R.S. Employer of incorporation or organization) Identification No.) 1719 West University Drive, Suite 187, Tempe, Arizona 85281 (Address of principal executive offices) (Zip Code) --------- If this Form relates to the registration of a class of debt securities and is effective upon filing pursuant to General Instruction A.(c)(1), please check the following box. [ ] If this Form relates to the registration of a class of debt securities and is to become effective simultaneously with the 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(g) of the Act: Common Stock, $.001 par value per share --------------------------------------- (Title of class) ================================================================================ INFORMATION REQUIRED IN REGISTRATION STATEMENT Item 1. Description of Registrant's Securities to be Registered. -------------------------------------------------------- Registrant's Registration Statement on Form SB-2 under the Securities Act of 1933, No. 333-11821, filed on September 12, 1996 and as amended from time to time thereafter, is incorporated herein by reference, including specifically the "Description of Capital Stock" appearing on pages 39 to 42 of the Prospectus contained therein. Item 2. Exhibits -------- 1. Specimen certificate for the Common Stock of Registrant 2. Certificate of Incorporation of Registrant, as amended - filed as Exhibit 3.1 to the Registration Statement on Form SB-2 under the Securities Act of 1933, No. 333- 11821, filed on September 12, 1996 and incorporated herein by reference. 3. Bylaws of Registrant, as amended - filed as Exhibit 3.2 to the Registration Statement on Form SB-2 under the Securities Act of 1933, No. 333-11821, filed on September 12, 1996 and incorporated herein by reference. -2- 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. M.D. Labs, Inc. (Registrant) Dated: October 29, 1996 By: /S/ HOOMAN NIKZAD ------------------------------------- Hooman Nikzad Chief Executive Officer and Director -3- EX-1 2 SPECIMEN COMMON STOCK CERTIFICATE COMMON STOCK COMMON STOCK NUMBER SHARES _____________ ____________ | | M.D. LABS | | |_____________| |____________| INCORPORATED UNDER THE LAWS SEE REVERSE FOR OF THE STATE OF DELAWARE CERTAIN DEFINITIONS CUSIP 55268R 10 1 THIS CERTIFIES THAT IS THE RECORD HOLDER OF FULLY PAID AND NONASSESSABLE SHARES OF THE COMMON STOCK, $.001 PAR VALUE PER SHARE, OF - -------------------------------- M.D. LABS, INC. ------------------------------- transferable on the books of the Corporation by the holder hereof in person or by duly authorized attorney upon surrender of this Certificate properly endorsed. This Certificate is not valid unless countersigned and registered by the Transfer Agent and Registrar. WITNESS the facisimile seal of the Corporation and the facsimile signatures of its duly authorized officers. Dated: M.D. Labs, Inc. /s/ Fred Djahandideh CORPORATE /s/ Todd P. Belfer Secretary SEAL President DELAWARE COUNTERSIGNED: Corporate Stock Transfer, Inc. 370 17th Street, Suite 2350 Denver, Colorado 80202 TRANSFER AGENT AND REGISTRAR BY AUTHORIZED SIGNATURE [COPYRIGHT SYMBOL] SECURITY-COLUMBIAN UNITED STATES BANKNOTE COMPANY 1960 M.D. LABS, INC. THE CORPORATION IS AUTHORIZED TO ISSUE STOCK IN ONE OR MORE CLASSES OR SERIES. THE CORPORATION WILL FURNISH WITHOUT CHARGE TO ANY STOCKHOLDER WHO SO REQUESTS A STATEMENT AS TO THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OR SERIES THEREOF AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND/OR RIGHTS. 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 entireties --------------- --------------- JT TEN - as joint tenants with right of (Cust) (Minor) survivorship and not as tenants under Uniform Gifts to Minors in common Act ----------------------------------- (State) UNIF TRF MIN ACT Custodian (until age ) ------------ ---------- (Cust) under Uniform Transfers ------------------ (Minor) to Minors Act ---------------------------- (State)
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, OF ASSIGNEE) ________________________________________________________________________________ ________________________________________________________________________________ __________________________________________________________________________Shares of the common stock represented by the within Certificate, and do hereby irrevocably constitute and appoint ________________________________________________________________________Attorney to transfer the said stock on the books of the within named Corporation with full power of substitution in the premises. Dated ______________________________ X ________________________________________ X ________________________________________ THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME(S) AS WRITTEN NOTICE: UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATEVER. Signature(s) Guaranteed By_____________________________________________________ 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. KEEP THIS CERTIFICATE IN A SAFE PLACE. IF IT IS LOST, STOLEN OR DESTROYED, THE CORPORATION MAY REQUIRE A BOND OF INDEMNITY AS A CONDITION TO THE ISSUANCE OF A REPLACEMENT CERTIFICATE. -----END PRIVACY-ENHANCED MESSAGE-----