U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Given Steven
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(Last) (First) (Middle)
c/o LaSalle Re Limited, 25 Church Street
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(Street)
Hamilton HM FX Bermuda
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
November 20, 1995
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
LaSalle Re Holdings Limited (NYSE: LSH)
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] Director [ ] 10% Owner
[ x ] Officer (give title below) [ ] Other (specify below)
Controller
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6. If Amendment, Date of Original (Month/Day/Year)
7. Individual or Joint/Group Filing (Check applicable line)
[ x ] Form filed by One Reporting Person
[ ] Form filed by More than One Reporting Person
*If the form is filed by more than one reporting person, see instruction
5(b) (v).
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Table I -- Non-Derivative Securities Acquired, Disposed of or Beneficially Owned
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<TABLE>
<CAPTION>
1. Title of Security 2. Amount of 3. Ownership 4. Nature
(Instr. 4) Securities Form Direct of Indirect
Beneficially (D) or Beneficial
Owned Indirect Ownership
(Instr. 4) (I) (Instr. 5) (Instr. 4)
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<S> <C> <C> <C>
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Common Shares -0-
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
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FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
<S> <C> <C> <C> <C> <C>
1. Title of Derivative 2. Date Exercisa- 3. Title and 4. Conver- 5. Owner- 6. Name of Indirect
Security (Instr. 3) ble and Expi- Amount of sion or ship Beneficial Ownership
ration Date Securities Exercise Form of (Instr. 5)
(Month/Day/Year) Underlying Price of Deriv-
Derivative Derivative ative
Security Security Security
Direct (D)
Indirect
(I)
(Instr. 5)
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Date Expiration Title Amount
Exercis- Date or Number
able of Shares
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</TABLE>
<PAGE>
Explanation of Responses:
/s/ Steven Given 10/8/97
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**Signature of Reporting Person Date
** Intentional misstatements or omissions of facts constitute Federal Criminal
Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, See Instruction 6 for procedure.
