A. | Name of issuer or person filing (Filer): Platinum Underwriters Holdings, Ltd. | |||
B. | This is (select one): | |||
þ | an original filing for the Filer | |||
o | 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. 333-128967 | ||||
Filed by: Platinum Underwriters Holdings, Ltd. | ||||
Date Filed (if filed concurrently, so indicate): October 12, 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 Securities and Exchange Commission, and |
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(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 October 12, 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 Filers 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 Agents 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. |
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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 12th day of October 2005 A.D. | ||||
Filer: Platinum Underwriters Holdings, Ltd. | ||||
By : | /s/ Joseph F. Fisher
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Joseph F. Fisher | ||||
Executive Vice President | ||||
and Chief Financial Officer | ||||
CT CORPORATION SYSTEM | ||||
By: /s/ Jill E. Kranz | ||||
Name: Jill E. Kranz |
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Title: Assistant Secretary | ||||
October 11, 2005
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