U.S. Securities and Exchange Commission
Washington, D.C. 20549
FORM F-N
APPOINTMENT OF AGENT FOR SERVICE OF PROCESS BY FOREIGN BANKS AND FOREIGN
INSURANCE COMPANIES AND CERTAIN OF THEIR HOLDING COMPANIES AND FINANCE
SUBSIDIARIES MAKING PUBLIC OFFERINGS OF SECURITIES IN THE UNITED STATES
A. Name of issuer or person filing ("Filer"): Platinum Underwriters
Holdings, Ltd.
B. This is (select one):
|X| an original filing for the Filer
|_| an amended filing for the Filer
C. Identify the filing in conjunction with which this Form is being
filed: S-4
Name of registrant: Platinum Underwriters Holdings, Ltd.
Form type: S-4
File Number (if known) No. 333-126883-01
Filed by: Platinum Underwriters Holdings, Ltd.
Date Filed (if filed concurrently, so indicate): July 26, 2005
D. The Filer is incorporated or organized under the laws of (Name of the
jurisdiction under whose laws the filer is organized or incorporated)
Bermuda
and has its principal place of business at (Address in full and
telephone number)
The Belvedere Building, 69 Pitts Bay Road, Pembroke, Bermuda HM 08
telephone number: (441) 295-7195
E. The Filer designates and appoints (Name of United States person
serving as agent)
CT CORPORATION SYSTEM ("Agent") located at 111 Eighth Avenue, New
York, New York 10011, (212) 894-8940 as the agent of the Filer upon
whom may be served any process, pleadings, subpoenas, or other papers
in:
(a) any investigation or administrative proceeding conducted by
the Commission, and
(b) any civil suit or action brought against the Filer or to which
the Filer has been joined as defendant or respondent in any
appropriate court in any place subject to the jurisdiction of
any state or of the United States or any of its territories or
possessions or of the District of Columbia, arising out of or
based on any offering made or purported to be made in
connection with the securities registered by the Filer on Form
S-4 filed on July 26, 2005 or any purchases or sales of any
security in connection therewith. The Filer stipulates and
agrees that any such civil suit or action or administrative
proceeding may be commenced by the service of process upon,
and that service of an administrative subpoena shall be
effected by service upon, such agent for service of process,
and that the service as aforesaid shall be taken and held in
all courts and administrative tribunals to be valid and
binding as if personal service thereof had been made.
F. Each person filing this Form stipulates and agrees to appoint a
successor agent for service of process and file an amended Form F-N
if the Filer discharges the Agent or the Agent is unwilling or unable
to accept service on behalf of the Filer at any time until six years
have elapsed from the date of the Filer's last registration statement
or report, or amendment to any such registration statement or report,
filed with the Commission under the Securities Act of 1933 or
Securities Exchange Act of 1934. Filer further undertakes to advise
the Commission promptly of any change to the Agent's name or address
during the applicable period by amendment of this form referencing
the file number of the relevant registration form in conjunction with
which the amendment is being filed.
G. Each person filing this form undertakes to make available, in person
or by telephone, representatives to respond to inquiries made by the
Commission staff, and to furnish promptly, when requested to do so by
the Commission staff, information relating to the securities
registered pursuant to the form referenced in paragraph E or
transactions in said securities.
The Filer certifies that it has duly caused this power of attorney,
consent, stipulation and agreement to be signed on its behalf by the
undersigned, thereunto duly authorized, in the City of Pembroke,
Country of Bermuda this 3rd day of August, 2005 A.D.
Filer: Platinum Underwriters Holdings, Ltd.
By : /s/ Joseph F. Fisher
----------------------------
Joseph F. Fisher
Executive Vice President and Chief Financial Officer
This statement has been signed by the following persons in the capacities and on
the dates indicated.
CT CORPORATION SYSTEM
By:/s/ Sheila Clark
--------------------------------
Name: Sheila Clark
Title: Assistant Secretary
August 3, 2005