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Section 1: 8-A12B (8-A12B)

 

 

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

 

PALOMAR HOLDINGS, INC.

(Exact name of registrant as specified in its charter)

 

Delaware

 

83-3972551

(State of incorporation or organization)

 

(I.R.S. Employer Identification No.)

 

7979 Ivanhoe Avenue

 

 

Suite 500

 

 

La Jolla, California

 

92037

(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, $0.0001 par value

 

The Nasdaq Stock Market LLC

 

 

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. x

 

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. o

 

If this form relates to the registration of a class of securities concurrently with a Regulation A offering, check the following box. o

 

Securities Act registration statement file number to which this form relates: 333-230346

 

Securities to be registered pursuant to Section 12(g) of the Act:  None.

 

 

 


 

Item 1.  Description of Registrant’s Securities to be Registered.

 

A description of the common stock, par value $0.0001 per share (the “Common Stock”), of Palomar Holdings, Inc., a Delaware corporation (the “Registrant”), to be registered hereunder is contained in the section entitled “Description of Capital Stock” in the prospectus that constitutes a part of the Registrant’s Registration Statement on Form S-1 (File No. 333-230346), as initially filed with the Securities and Exchange Commission (the “Commission”) on March 15, 2019, including exhibits, and as subsequently amended (the “Registration Statement”), which information is hereby incorporated by reference.  In addition, any form of prospectus subsequently filed by the Registrant with the Commission pursuant to Rule 424(b) under the Securities Act that constitutes part of the Registration Statement shall be deemed to be incorporated by reference herein.

 

Item 2.  Exhibits.

 

Pursuant to the Instructions as to Exhibits with respect to Form 8-A, no exhibits are required to be filed because no other securities of the Registrant are registered on The Nasdaq Stock Market LLC, and the securities registered hereby are not being registered pursuant to Section 12(g) of the Securities Exchange Act of 1934, as amended.

 

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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, thereto duly authorized.

 

Date: April 15, 2019

Palomar Holdings, Inc.

 

 

 

 

 

 

 

By:

/s/ Mac Armstrong

 

 

Name: Mac Armstrong

 

 

Title: Chief Executive Officer

 

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