Form: 8-A12B

Form for the registration / listing of a class of securities on a national securities exchange pursuant to Section 12(b)

January 4, 2013



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
     
 
ACASTI PHARMA INC.
(Exact name of registrant as specified in its charter)
     
 
 
   
Canada
Not applicable
(State of incorporation or organization)
(I.R.S. Employer
Identification No.)
   
545 Promenade Du Centropolis Suite 100
Laval, Quebec
H7T 0A3
(Address of principal executive offices)
(Zip Code)
 
Securities to be registered pursuant to Section 12(b) of the Act:
   
Title of each class
to be so registered
Name of each exchange on which
each class is to be registered
Class A Common Shares The NASDAQ Capital Market
   
 
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.    ¨
 
Securities Act registration statement file number to which this form relates (if applicable): not applicable
 
Securities to be registered pursuant to Section 12(g) of the Act: None

 
 

 
INFORMATION REQUIRED IN REGISTRATION STATEMENT
 
Item 1.
Description of Registrant’s Securities to be Registered.
 
Acasti Pharma Inc. hereby incorporates by reference the description of its securities to be registered hereunder contained in the section entitled “Disclosure of Outstanding Security Data on Fully Diluted Basis” in the document entitled “Listing Application For the Listing of the Class A Common Shares of Acasti Pharma Inc.,”  included as Exhibit 99.3 to its Form 40-F Registration Statement (File No. 000-54771)  initially filed with the Securities and Exchange Commission on July 20, 2012, as amended on July 24, 2012.
 
Item  2.
Exhibits.
 
 
1.1
Listing Application For the Listing of the Class A Common Shares of Acasti Pharma Inc. on the TSX Venture Exchange (incorporated by reference to Exhibit 99.3 to the Registration Statement of Acasti Pharma Inc. on Form 40-F filed with the Securities and Exchange Commission on July 20, 2012 (File No. 000-54771)).
 
 
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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: January 4, 2013
 
     
 
ACASTI PHARMA INC.
     
 
By:
/s/ Xavier Harland
    Name:     Xavier Harland
    Title:       Chief Financial Officer

 
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EXHIBIT INDEX
 
     
Exhibit Number
 
Description of Exhibit
     
1.1
 
Listing Application For the Listing of the Class A Common Shares of Acasti Pharma Inc. on the TSX Venture Exchange (incorporated by reference to Exhibit 99.3 to the Registration Statement of Acasti Pharma Inc. on Form 40-F filed with the Securities and Exchange Commission on July 20, 2012 (File No. 000-54771)).
     


 
 
 
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