AS FILED WITH THE SECURITIES AND EXCHANGE COMMISSION ON DECEMBER 6, 2001.
REGISTRATION NO. 34-_______
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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FORM 8-A
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FOR REGISTRATION OF CERTAIN CLASSES OF
SECURITIES PURSUANT TO SECTION 12(b) OR 12(g) OF
THE SECURITIES EXCHANGE ACT OF 1934
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LASIK AMERICA, INC.
(NAME OF SMALL BUSINESS ISSUER IN ITS CHARTER)
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Nevada 88-0490720
(State or (I.R.S. Employer Identification
Jurisdiction of Incorporation Number)
or Organization)
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6646 Indian School Road, N.E.
Albuquerque, New Mexico 87110
505-837-2020
(Address and Telephone Number of
Principal Executive Offices)
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
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Common Stock, $.001 par value Over-the-Counter Bulletin Board
Redeemable Common Stock Over-the-Counter Bulletin Board
Purchase Warrants
If this form relates to the registration of a class of securities pursuant to
Section 12(b) of the Securities Exchange Act and is effective pursuant to
General Instruction A.(c), check the following box. [X]
If this form relates to the registration of a class of securities pursuant to
Section 12(g) of the Securities Exchange Act and is effective pursuant to
General Instruction A.(d), check the following box. [ ]
Securities Act registration statement file number to which this form relates:
333-68942
Securities to be registered pursuant to Section 12(g) of the Act:
None
(Title of Classes)
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ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED.
The securities to be registered are shares of Common Stock,
par value $.001 per share ("Common Stock"), of LASIK America, Inc.
("Registrant"), and Redeemable Common Stock Purchase Warrants, each warrant
exercisable to purchase one share of Common Stock at an exercise price of $7.20
per share. A description of the Common Stock and the Redeemable Common Stock
Purchase Warrants is set forth under the caption "Description of Securities" in
the Registrant's Registration Statement on Form SB-2 (Reg No. 333-68942, as
amended, which has been filed by the Registrant with the Securities and Exchange
Commission ("Commission"), and will be included in a form of prospectus to be
filed pursuant to Rule 424(b) under the Securities Act of 1933. Such prospectus
and description is incorporated by reference herein.
ITEM 2. EXHIBITS.
1.1 Registrant's Registration Statement on Form SB-2 (incorporated
by reference to the entirety of the Registrant's Registration
Statement on Form SB-2 (Reg No. 333-68942), filed with the
Commission on September 4, 2001.
1.2 Amendment No. 1 to Registrant's Registration Statement on Form
SB-2 (incorporated by reference to the entirety of the
Registrant's Registration Statement on Form SB-2 (Reg No.
333-68942), filed with the Commission on September 7, 2001.
1.3 Amendment No. 2 to Registrant's Registration Statement on Form
SB-2 (incorporated by reference to the entirety of the
Registrant's Registration Statement on Form SB-2 (Reg No.
333-68942), filed with the Commission on October 18, 2001.
1.4 Amendment No. 3 to Registrant's Registration Statement on Form
SB-2 (incorporated by reference to the entirety of the
Registrant's Registration Statement on Form SB-2 (Reg No.
333-68942), filed with the Commission on November 15, 2001.
1.5 Amendment No. 4 to Registrant's Registration Statement on Form
SB-2 (incorporated by reference to the entirety of the
Registrant's Registration Statement on Form SB-2 (Reg No.
333-68942), filed with the Commission on November 28, 2001.
1.6 Certificate of Incorporation of the Registrant (incorporated by
reference to Exhibits 3.1 to the Registrant's Registration
Statement on Form SB-2 (Reg No. 333-68942), filed with the
Commission on September 4, 2001.
1.7 Bylaws of the Registrant (incorporated by reference to Exhibits
3.2 to the Registrant's Registration Statement on Form SB-2 (Reg
No. 333-68942), filed with the Commission on September 4, 2001.
1.8 Form of Common Stock certificate (incorporated by reference to
Exhibit 4.0 to the Registrant's Registration Statement on Form
SB-2 (Reg No. 333-68942), filed with the Commission on November
28, 2001.
1.9 Form of Common Stock Purchase Warrant (incorporated by reference
to Exhibit 4.1 to the Registrant's Registration Statement on
Form SB-2 (Reg No. 333-68942), filed with the Commission on
November 28, 2001.
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.
LASIK AMERICA, INC.
By:_________________________________
Howard P. Silverman
President and Chief Executive Officer
Dated: December 6, 2001.