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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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
SECTION 13 AND 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934
Commission File Number: 1-12800
EXECUTIVE RISK INC.
(Exact name of Registrant as specified in its charter)
82 HOPMEADOW STREET, SIMSBURY, CONNECTICUT 06070 860/408-2000
(Address, including zip code, and telephone number, including area code, of
Registrant's principal executive offices)
COMMON STOCK, $ .01 PAR VALUE
AND
ASSOCIATED COMMON STOCK PURCHASE RIGHTS, PAR
VALUE $.01 PER SHARE
(Title of each class of securities covered by this Form)
N/A
(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 provisions(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 as of the certification date or notice
date: ONE (1)
Pursuant to the requirements of the Securities Exchange Act of 1934, Executive
Risk Inc. has caused this certification/notice to be signed on its behalf by the
undersigned duly authorized person.
DATE: July 19, 1999 BY: /s/ Stephen J. Sills
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Name: Stephen J. Sills
Title: President and Chief Executive Officer
