8-A12G 1 d8a12g.htm FORM 8-A 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
 
 
IMPAC Medical Systems, Inc.
(Exact Name of Registrant as Specified in Its Charter)
 
Delaware
  
94-3109238
(State of Incorporation or Organization)
  
(I.R.S. Employer
Identification no.)
 
100 West Evelyn Avenue, Mountain View, CA
  
94041
(Address of Principal Executive Offices)
  
(Zip Code)
 
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), please 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), please check the following box. x
 
Securities Act registration statement file number to which this form relates:
  
333-89724
   
(If Applicable)
 
Securities to be registered pursuant to Section 12(b) of the Act:
 
Title of Each Class
to be so Registered
     
Name of Each Exchange on Which Each
Class is to be Registered
    
    
 
Securities to be registered pursuant to Section 12(g) of the Act:
 
Common Stock, $0.001 par value
(Title of Class)
 
(Title of Class)
 

 
Item 1.    Description of Registrant’s Securities to be Registered.
 
See “Description of Capital Stock” included in the Registration Statement on Form S-1, No. 333-89724 (the “Registration Statement”) of IMPAC Medical Systems, Inc. (the “Registrant”) as originally filed or as subsequently amended, which was filed with the Securities and Exchange Commission on June 4, 2002 under the Securities Act of 1933, as amended, and is hereby incorporated by reference pursuant to Rule 12b-23 of the Securities Exchange Act of 1934.
 
Item 2.    Exhibits.
 
1.1
  
Amended and Restated Certificate of Incorporation. See Exhibit 3.2 to the Registrant’s Registration Statement on Form S-1, which is hereby incorporated by reference.
1.2
  
Amended and Restated Bylaws. See Exhibit 3.4 to the Registrant’s Registration Statement on Form S-1, which is hereby incorporated by reference.
1.3
  
Specimen Common Stock Certificate. See Exhibit 4.1 to the Registrant’s Registration Statement on Form S-1, which is hereby incorporated by reference.

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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, thereunto duly authorized.
 
Dated:  November 8, 2002
  
IMPAC MEDICAL SYSTEMS, INC.
   
By:
  
/s/ Joseph K. Jachinowski
   
Name:
  
Joseph K. Jachinowski
   
Title:
  
President & Chief Executive Officer

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