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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 12(g) OF THE

SECURITIES EXCHANGE ACT OF 1934

 

 

 

NI HOLDINGS, INC.

(Exact name of registrant as specified in its charter)

 

 

 

North Dakota

(State of incorporation or organization)

 

1101 First Avenue North

Fargo, North Dakota

(Address of principal executive offices)

81-2683619

(IRS Employer Identification No.)

 

 

58102

(Zip Code)

 

Securities to be registered pursuant to Section 12(b) of the Act:

 

Title of each class

to be so registered

Common Stock

Name of each exchange on which

each class is to be registered

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. ☒

 

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:

333-214057

 

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

 

For a description of the securities to be registered hereunder, reference is made to the information set forth under the heading “Description of Our Capital Stock” in the Registrant’s Registration Statement on Form S-1, as amended (File No. 333-214057), which information is hereby incorporated herein by reference.  The description of the Registrant’s common stock included in any prospectus subsequently filed by the Registrant pursuant to Section 424(b) of the Securities Act of 1933, as amended, shall also be deemed to be incorporated herein by reference

 

 

Item 2. Exhibits

 

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.

 

 

 
 

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.

 

  NI Holdings, Inc.
     
Dated:  December 22, 2016 By:   /s/ Michael J. Alexander
    Michael J. Alexander
    President and Chief Executive Officer