U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
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
(Print or Type Responses)
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1. Name and Address of Reporting Person*
Kuzuhara, Isao
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(Last) (First) (Middle)
5-16-26 Koenju-Minami
Suginami-Ku
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(Street)
Tokyo Japan 166-0003
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
May 8, 2000
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
ESG Re Limited (ESREF)
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [_] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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6. If Amendment, Date of Original (Month/Day/Year)
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7. Individual or Joint/Group Filing (Check applicable line)
[X] Form Filed by One Reporting Person
[_] Form Filed by More than One Reporting Person
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Table I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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<TABLE>
<CAPTION>
2. Amount of Securities 3. Ownership Form:
1. Title of Security Beneficially Owned Direct (D) or
(Instr. 3) at end of Month Indirect (I) 4. Nature of Indirect Beneficial Ownership
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<S> <C> <C> <C>
Common shares, pare value $1 per share None
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Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the Form is filed by more than one Reporting Person, see Instruction
5(b)(v).
Potential persons who are to respond to the collection of Information
contained in this form are not required to respond unless the form displays
a currently valid OMB control number.
(Over)
SEC 1474(3-99)
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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>
5. Owner-
3. Title and Amount of Underlying ship
Securities Form of
(Instr. 4) Derivative
2. Date Exercisable --------------------------------- 4. Conver- Security:
Expiration Date Amount sion or Direct 6. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
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</TABLE>
Explanation of Responses:
/s/ Isao Kuzuhara May 18, 2000
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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.
Potential persons who are to respond to the collection of Information
contained in this form are not required to respond unless the form displays
a currently valid OMB control number.
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