1 FORM 8-A SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES PURSUANT TO SECTION 12(b) or (g) OF THE SECURITIES EXCHANGE ACT OF 1934 NEW BEVERLY HOLDINGS, INC. ---------------------------------------------------- (Exact name of registrant as specified in its charter) Delaware 62-1691861 ------------------------ ------------------- (State of incorporation (I.R.S. Employer or organization) Identification No.) 5111 Rogers Avenue, Suite 40-A Fort Smith, Arkansas 72919 ------------------------------------------------- (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 Common Stock, $0.10 Par Value New York Stock Exchange Pacific Exchange Securities to be registered pursuant to Section 12(g) of the Act: None ------------------ (Title of class) 2 Item 1: Description of Registrant's Securities to be Registered. The description of such securities is hereby incorporated by reference to the material set forth under the caption "Description of New Beverly Capital Stock" in the Prospectus which constitutes a part of the Registration Statement on Form S-1, File No. 333-28521, under the Securities Act of 1933, as amended (the "Registration Statement"). Item 2: Exhibits. Exhibit Number Description - ------ ----------- 3.1 -- Certificate of Incorporation of New Beverly Holdings, Inc. dated April 15, 1997 (incorporated by reference to Exhibit 3.1 to New Beverly Holdings, Inc.'s Registration Statement on Form S-1 filed June 4, 1997 (File No. 333-28521)). 3.2 -- Amended Certificate of Incorporation of New Beverly Holdings, Inc. dated May 29, 1997 (incorporated by reference to Exhibit 3.2 to New Beverly Holdings, Inc.'s Registration Statement on Form S-1 filed June 4, 1997 (File No. 333-28521)). 3.3 -- Bylaws of New Beverly Holdings, Inc. (incorporated by reference to Exhibit 3.4 to New Beverly Holdings, Inc.'s Registration Statement on Form S-1 filed June 4, 1997 (File No. 333-28521)). 4.1 -- Indenture dated as of February 1, 1996 between Beverly Enterprises, Inc. and Chemical Bank, as Trustee, with respect to Beverly Enterprises, Inc.'s 9% Senior Notes due February 15, 2006 (incorporated by reference to Exhibit 4.1 to Beverly Enterprises, Inc.'s Annual Report on Form 10-K for the year ended December 31, 1995). 4.2 -- Form of Second Supplemental Indenture dated , 1997 between Beverly Enterprises, Inc., New Beverly Holdings, Inc., certain subsidiaries of Beverly Enterprises, Inc. as guarantors and The Chase Manhattan Bank, as Trustee, with respect to Beverly's 9% Senior Notes due February 15, 2006 (incorporated by reference to Exhibit 4.2 to Beverly Enterprises, Inc.'s and New Beverly Holdings, Inc's (and additional Co-Registrants') Registration Statement on Form S-4 filed on September 8, 1997 (File Nos. 333-25137 and 333-35137-01)). 4.3 -- Indenture dated as of March 15, 1983 between Beverly Enterprises and Manufacturers Hanover Trust Company, Trustee with respect to Beverly's 7 5/8% Convertible Subordinated Debentures due March 15, 2003 (incorporated by reference to Exhibit 4.2 to Beverly's Registration Statement on Form S-3 dated March 10, 1983 (File No. 2-82266)). 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. NEW BEVERLY HOLDINGS, INC. (Registrant) By: /s/ Scott Tabakin Name: Scott Tabakin Title: Executive Vice President, Chief Financial Officer and Director Date: October 15, 1997 3 INDEX TO EXHIBITS Exhibit Number Description - ------ ----------- 3.1 -- Certificate of Incorporation of New Beverly Holdings, Inc. dated April 15, 1997 (incorporated by reference to Exhibit 3.1 to New Beverly Holdings, Inc.'s Registration Statement on Form S-1 filed June 4, 1997 (File No. 333-28521)). 3.2 -- Amended Certificate of Incorporation of New Beverly Holdings, Inc. dated May 29, 1997 (incorporated by reference to Exhibit 3.2 to New Beverly Holdings, Inc.'s Registration Statement on Form S-1 filed June 4, 1997 (File No. 333-28521)). 3.3 -- Bylaws of New Beverly Holdings, Inc. (incorporated by reference to Exhibit 3.4 to New Beverly Holdings, Inc.'s Registration Statement on Form S-1 filed June 4, 1997 (File No. 333-28521)). 4.1 -- Indenture dated as of February 1, 1996 between Beverly Enterprises, Inc. and Chemical Bank, as Trustee, with respect to Beverly Enterprises, Inc.'s 9% Senior Notes due February 15, 2006 (incorporated by reference to Exhibit 4.1 to Beverly Enterprises, Inc.'s Annual Report on Form 10-K for the year ended December 31, 1995). 4.2 -- Form of Second Supplemental Indenture dated , 1997 between Beverly Enterprises, Inc., New Beverly Holdings, Inc., certain subsidiaries of Beverly Enterprises, Inc. as guarantors and The Chase Manhattan Bank, as Trustee, with respect to Beverly's 9% Senior Notes due February 15, 2006. (incorporated by reference to Exhibit 4.2 to Beverly Enterprises, Inc.'s and New Beverly Holdings, Inc's (and additional Co-Registrants') Registration Statement on Form S-4 filed on September 8, 1997 (File Nos. 333-25137 and 333-35137-01)). 4.3 -- Indenture dated as of March 15, 1983 between Beverly Enterprises and Manufacturers Hanover Trust Company, Trustee with respect to Beverly's 7 5/8% Convertible Subordinated Debentures due March 15, 2003 (incorporated by reference to Exhibit 4.2 to Beverly's Registration Statement on Form S-3 dated March 10, 1983 (File No. 2-82266)).