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 ------------ ASSURANT, INC. -------------------------------------------------------------------------------- (Exact name of registrant as specified in its charter) Delaware 39-1126612 -------------------------------------------------------------------------------- (State of incorporation or organization) (I.R.S. Employer Identification No.) One Chase Manhattan Plaza, 41st Floor New York, NY 10005 Telephone: (212) 859-7000 -------------------------------------------------------------------------------- (Address of principal executive offices) 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: No. 333-109984 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, par value $0.01 per share New York Stock Exchange --------------------------------------- ------------------------------ Securities to be registered pursuant to Section 12(g) of the Act: None -------------------------------------------------------------------------------- ITEM 1. DESCRIPTION OF REGISTRANT'S SECURITIES TO BE REGISTERED. Information with respect to the Common Stock, par value $0.01 per share, is incorporated herein by reference to the section captioned "Description of Share Capital" in the registrant's prospectus included in the Registration Statement on Form S-1 (Registration No. 333-109984), as amended (the "Registration Statement"), filed under the Securities Act of 1933, as amended, with the Securities and Exchange Commission (the "Commission"). The Registration Statement was originally filed with the Commission on October 24, 2003 and amended on December 12, 2003, January 13, 2004 and may hereafter be amended. Any form of prospectus that constitutes part of the Registration Statement and is filed by the Registrant pursuant to Rule 424(b) under the Securities Act of 1933, as amended, shall be deemed incorporated herein by reference. ITEM 2. EXHIBITS. None 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. ASSURANT, INC. Dated: February 2, 2004 By: /s/ J. KERRY CLAYTON -------------------------- Name: J. Kerry Clayton Title: President and Chief Executive Officer 2