SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 8-AG12
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(b) OR (g) OF THE
SECURITIES EXCHANGE ACT OF 1934
Conscious Intention, Inc.
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(Exact name of registrant as specified in its charter)
Nevada 94-3409449
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(State of incorporation (IRS Employer
or organization) Identification No.)
6620 Lake Washington Blvd. NE, Ste 301
Seattle, WA 98033
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(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), 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), check the following box. [X]
Securities Act registration statement file number to which this Form relates:
333-86078
Securities to be registered pursuant to Section 12(b) of the Act: None
Securities to be registered pursuant to Section 12(g) of the Act:
Common Stock, $0.001 par value per share
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(Title of class)
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ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED
The description of the common stock of the registrant registered
hereby is incorporated by reference to the description of the registrant's
common stock set forth under the heading "Description of capital stock" in the
registrant's registration statement on Form SB-2 (File No. 333-86078), as filed
with the Securities and Exchange Commission on April 2, 2002, and any amendments
to such registration statement filed subsequently thereto (the "SB-2
registration statement").
Item 2. EXHIBITS
The following exhibits are filed as part of this registration statement:
1. Certificate of Incorporation of the registrant.*
2. Bylaws of the registrant.*
3. Form of common stock certificate of the registrant.*
* Incorporated by reference to the registrant's registration statement on
Form SB-2 (SEC File No. 333-86078) as filed with the Securities and
Exchange Commission on April 2, 2002.
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SIGNATURES
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.
Date: August 14, 2003 Conscious Intention, Inc.
By: /s/ Sylva Leduc
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Sylva Leduc
Chief executive officer and director