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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 0-18324
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CII FINANCIAL, INC.
(Exact Name of Registrant as Specified in Its Charter)
5627 Gibraltar Drive
Pleasanton, California 94588
(510) 416-8700
(Address, Including Zip Code, and Telephone Number, Including Area Code,
of Registrant's Principal Executive Offices)
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Common Stock, Stated Value $.50 Per Share
7 1/2% Convertible Subordinated Debentures Due 2001
(Title of Each Class of Securities Covered by this Form)
None
(Title 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 12h-3(b)(1)(ii) [ ]
Rule 12g-4(a)(1)(ii) [ ] Rule 12h-3(b)(2)(i) [ ]
Rule 12g-4(a)(2)(i) [ ] Rule 12h-3(b)(2)(ii) [ ]
Rule 12g-4(a)(2)(ii) [ ] Rule 15d-6 [ ]
Rule 12h-3(b)(1)(i) [X]
Approximate number of holders of record of Common Stock, stated value $.50 per
share, as of the certification or notice date: 1
Approximate number of holders of record of the 7 1/2% Convertible
Subordinated Debentures due 2001 as of the certification or notice date: 32
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of
1934, CII Financial, Inc. has caused this certification/notice to be signed on
its behalf by the undersigned duly authorized person.
CII FINANCIAL, INC.
DATE: May 22, 1996 By: /s/ Richard E. Dobson
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Richard E. Dobson
Executive Vice President,
General Counsel and Secretary
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