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 SECTIONS 13 AND 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
COMMISSION FILE NUMBER 333-34690
Retirement Plan for Field Underwriters of MONY Life Insurance Company
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(Exact name of registrant as specified in its charter)
1290 Avenue of the Americas
New York, New York 10104
(212) 554-1234
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(Address, including zip code, and telephone number,
including area code, of registrant's principal executive offices)
Interests of Participants in the Retirement Plan for Field Underwriters
of MONY Life Insurance Company
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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 12h-3(b)(l)(i) |X|
Rule 12g-4(a)(l)(ii) |_| Rule 12h-3(b)(l)(ii) |_|
Rule 12g-4(a)(2)(i) |_| Rule 12h-3(b)(2)(i) |_|
Rule 12g-4(a)(2)(ii) |_| Rule 12h-3(b)(2)(ii) |_|
Rule 15d-6 |X|
Approximate number of holders of record as of the certification or
notice date: 0
Pursuant to the requirements of the Securities Exchange Act of 1934,
the Retirement Plan for Field Underwriters of MONY Life Insurance Company has
caused this certification/notice to be signed on its behalf by the undersigned
duly authorized person.
Date: June 27, 2005 RETIREMENT PLAN FOR FIELD UNDERWRITERS OF
MONY LIFE INSURANCE COMPANY
By: /s/ Jennifer Blevins
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Jennifer Blevins, Chairperson of the MONY Life
Insurance Company Officers Committee on Benefit
Plans, Plan Administrator, and Executive Vice
President of MONY Life Insurance Company
Instruction: This form is required by Rules 12g-4, 12h-3 and 15d-6 of the
General Rules and Regulations under the Securities Exchange Act of 1934. The
registrant shall file with the Commission three copies of Form 15, one of which
shall be manually signed. It may be signed by an officer of the registrant, by
counsel or by any other duly authorized person. The name and title of the person
signing the form shall be typed or printed under the signature.