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
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A. Name of issuer or person filing ("Filer"): Platinum Underwriters Holdings,
Ltd.
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B. This is (select one):
[X] an original filing for the Filer
[ ] an amended filing for the Filer
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C. Identify the filing in conjunction with which this Form is being filed:
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Name of registrant: Platinum Underwriters Holdings, Ltd.
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Form type: S-3
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File Number (if known) No. 333-113823
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Filed by: Platinum Underwriters Holdings, Ltd.
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Date Filed (if filed concurrently, so indicate): April 20, 2004
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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
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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
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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-3 filed on April 5, 2004 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.
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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.
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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 is 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 20th day of April, 2004 A.D.
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Filer: Platinum Underwriters Holdings, Ltd.
By: /s/ Michael E. Lombardozzi
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Michael E. Lombardozzi
Executive Vice President,
General Counsel and Secretary
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This statement has been signed by the following persons in the capacities and on
the dates indicated.
CT CORPORATION SYSTEM
By: /s/ Jill E. Kranz
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Name: Jill E. Kranz
Title: Assistant Secretary
April 16, 2004