1 --------------------------- OMB APPROVAL --------------------------- OMB Number: 3235-0056 Expires:September 30, 2000 Estimated average burden hours per response:......8 --------------------------- 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 ANSYS DIAGNOSTICS, INC. - -------------------------------------------------------------------------------- (Exact name of registrant as specified in its charter) DELAWARE 33-0316510 - -------------------------------------------------------------------------------- (State of incorporation (I.R.S. Employer or organization Identification No.) 25200 COMMERCENTRE DRIVE, LAKE FOREST, CALIFORNIA 92630 - -------------------------------------------------------------------------------- (Address of principal executive offices) (Zip Code) 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 - -------------------------------------------------------------------------------- None 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 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: 333-72665 (if applicable) Securities to be registered pursuant to Section 12(g) of the Act: COMMON STOCK, PAR VALUE $0.0001 PER SHARE - -------------------------------------------------------------------------------- (Title of Class) - -------------------------------------------------------------------------------- (Title of Class) INFORMATION REQUIRED IN REGISTRATION STATEMENT ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED. This registration statement relates to the registration with the Securities and Exchange Commission of shares of Common Stock, par value $0.0001 (the "Common Stock"), of ANSYS Diagnostics, Inc., a Delaware corporation (the "Registrant"). The description of the Common Stock to be registered hereunder set forth under the caption "Description of Capital Stock" at page 63 of the Registrant's Registration Statement on Form S-1, Registration No. 333-72665 (the "Registration Statement"), filed with the Securities and Exchange Commission, as amended, is incorporated herein by this reference. 2 ITEM 2. EXHIBITS. The following documents are included as Exhibits to Registrant's Registration Statement and incorporated herein by this reference: Form S-1 Exhibit Description Exhibit Number ------------------- -------------- (a) Certificate of Incorporation of ANSYS 3.1 (b) Bylaws of ANSYS 3.2 (c) Specimen certificate representing shares of common stock of the Company 4.1 2 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, thereunto duly authorized. (Registrant) ANSYS Diagnostics, Inc. Date: April 26, 1999 By: /s/ STEPHEN K. SCHULTHEIS ------------------------------ Stephen K. Schultheis, Chief Executive Officer and President 3