UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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FORM 15
CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER SECTION 12(G) OF
THE SECURITIES EXCHANGE ACT OF 1934 OR SUSPENSION OF DUTY TO FILE REPORTS UNDER
SECTIONS 13 AND 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934.
COMMISSION FILE NUMBER(S): 333-02093
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VALLEY FORGE LIFE INSURANCE COMPANY
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(Exact Name of Registrant as Specified in Its Charter)
CNA Plaza, 43 South, Chicago, Illinois 60685 (312) 822-6597
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(Address, including zip code, and telephone number, including area
code, of registrant's principal executive offices)
SINGLE PREMIUM DEFERRED MODIFIED GUARANTEED ANNUITY CONTRACTS
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(Title of each class of securities covered by this Form)
NONE
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(Titles of all other classes of securities for which a duty to
file reports under section 13(a) or 15(d) remains)
Please place an X in the box(es) to designate the appropriate rule provision(s)
relied upon to terminate or suspend the duty to file reports:
Rule 12g-4(a)(1)(i) [ ]
Rule 12g-4(a)(1)(ii) [ ]
Rule 12g-4(a)(2)(i) [ ]
Rule 12g-4(a)(2)(ii) [ ]
Rule 12h-3(b)(1)(i) [ ]
Rule 12h-3(b)(1)(ii) [ ]
Rule 12h-3(b)(2)(i) [ ]
Rule 12h-3(b)(2)(i) [ ]
Rule 12h-3(b)(2)(ii) [ ]
Rule 15d-6 [ X ]
Approximate number of holders as of the certification or notice date: 8
Pursuant to the requirements of the Securities Exchange Act of 1934, Valley
Forge Life Insurance Company has caused this certificate/notice to be signed on
its behalf by the undersigned duly authorized person.
DATE: 1-28-00 BY: /s/DAVID L. STONE
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David L. Stone
Group Vice President