EXHIBIT 25.3
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FORM T-1
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF ELIGIBILITY
UNDER THE TRUST INDENTURE ACT OF 1939 OF A
CORPORATION DESIGNATED TO ACT AS TRUSTEE
CHECK IF AN APPLICATION TO DETERMINE
ELIGIBILITY OF A TRUSTEE PURSUANT TO
SECTION 305(b)(2) [_]
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BNY MIDWEST TRUST COMPANY
(formerly known as CTC Illinois Trust Company)
(Exact name of trustee as specified in its charter)
Illinois 36-3800435
(State of incorporation (I.R.S. employer
if not a U.S. national bank) identification no.)
2 N. LaSalle Street
Suite 1020
Chicago, Illinois 60602
(Address of principal executive offices) (Zip code)
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KINGSWAY FINANCIAL SERVICES INC.
(Exact name of obligor as specified in its charter)
Ontario Not Applicable
(State or other jurisdiction of (I.R.S. employer
incorporation or organization) identification no.)
5310 Explorer Drive, Suite 200
Mississauga, Ontario L4W 5H8
(Address of principal executive offices) (Zip code)
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Guarantee of Trust Preferred Securities of
Kingsway Financial Capital Trust I
(Title of the indenture securities)
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1. General information. Furnish the following information as to the Trustee:
(a) Name and address of each examining or supervising authority to which
it is subject.
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Name Address
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Office of Banks & Trust Companies of 500 E. Monroe Street
the State of Illinois Springfield, Illinois 62701-1532
Federal Reserve Bank of Chicago 230 S. LaSalle Street
Chicago, Illinois 60603
(b) Whether it is authorized to exercise corporate trust powers.
Yes.
2. Affiliations with Obligor.
If the obligor is an affiliate of the trustee, describe each such
affiliation.
None.
16. List of Exhibits.
1. A copy of Articles of Incorporation of BNY Midwest Trust Company
(formerly CTC Illinois Trust Company, formerly Continental Trust
Company) as now in effect. (Exhibit 1 to Form T-1 filed with the
Registration Statement No. 333-47688.)
2,3. A copy of the Certificate of Authority of the Trustee as now in
effect, which contains the authority to commence business and a grant
of powers to exercise corporate trust powers. (Exhibit 2 to Form T-1
filed with the Registration Statement No. 333-47688.)
4. A copy of the existing By-laws of the Trustee. (Exhibit 4 to Form T-1
filed with the Registration Statement No. 333-47688.)
6. The consent of the Trustee required by Section 321(b) of the Act.
(Exhibit 6 to Form T-1 filed with the Registration Statement No.
333-47688.)
7. A copy of the latest report of condition of the Trustee published
pursuant to law or to the requirements of its supervising or
examining authority.
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SIGNATURE
Pursuant to the requirements of the Act, the Trustee, BNY Midwest Trust
Company, a corporation organized and existing under the laws of the State of
Illinois, has duly caused this statement of eligibility to be signed on its
behalf by the undersigned, thereunto duly authorized, all in The City of
Chicago, and State of Illinois, on the 12th day of September, 2003.
BNY Midwest Trust Company
By: /s/ J. BARTOLINI
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Name: J. BARTOLINI
Title: VICE PRESIDENT
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OFFICE OF BANKS AND REAL ESTATE
Bureau of Banks and Trust Companies
CONSOLIDATED REPORT OF CONDITION
OF
BNY Midwest Trust Company
2 North LaSalle Street
Suite 1020
Chicago, Illinois 60602
Including the institution's domestic and foreign subsidiaries completed as of
the close of business on March 31, 2003, submitted in response to the call of
the Office of Banks and Real Estate of the State of Illinois.
ASSETS Thousands of Dollars
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1. Cash and Due from Depository Institutions ........................... 28,746
2. U.S. Treasury Securities ............................................ - 0 -
3. Obligations of States and Political Subdivisions .................... - 0 -
4. Other Bonds, Notes and Debentures ................................... - 0 -
5. Corporate Stock ..................................................... - 0 -
6. Trust Company Premises, Furniture, Fixtures and Other
Assets Representing Trust Company Premises .......................... 831
7. Leases and Lease Financing Receivables .............................. - 0 -
8. Accounts Receivable ................................................. 4,538
9. Other Assets
(Itemize amounts greater than 15% of Line 9)
GOODWILL .................................................... 86,813
86,881
10. TOTAL ASSETS ........................................................ 120,996
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OFFICE OF BANKS AND REAL ESTATE
Bureau of Banks and Trust Companies
CONSOLIDATED REPORT OF CONDITION
OF
BNY Midwest Trust Company
2 North LaSalle Street
Suite 1020
Chicago, Illinois 60602
LIABILITIES Thousands of Dollars
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11. Accounts Payable ........................................ 14
12. Taxes Payable ........................................... - 0 -
13. Other Liabilities for Borrowed Money .................... 25,425
14. Other Liabilities .......................................
(Itemize amounts greater than 15% of Line 14)
Reserve for Taxes ........................... 3,991
Taxes due to Parent ......................... 5,181
9,480
15. TOTAL LIABILITIES 34,919
EQUITY CAPITAL
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16. Preferred Stock ..................................... - 0 -
17. Common Stock ........................................ 2,000
18. Surplus ............................................. 62,130
19. Reserve for Operating Expenses ...................... - 0 -
20. Retained Earnings (Loss) ............................ 21,947
21. TOTAL EQUITY CAPITAL ................................ 86,077
22. TOTAL LIABILITIES AND EQUITY CAPITAL ................ 120,996
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I, Keith A. Mica, Vice President
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(Name and Title of Officer Authorized to Sign Report)
of BNY Midwest Trust Company certify that the information contained in this
statement is accurate to the best of my knowledge and belief. I understand that
submission of false information with the intention to deceive the Commissioner
or his Administrative officers is a felony.
/s/ Keith A. Mica
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(Signature of Officer Authorized to Sign Report)
Sworn to and subscribed before me this 29th day of July, 2003. My Commission
expires May 15, 2007.
/s/ Joseph A. Giacobino, Notary Public
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(Notary Seal)
Person to whom Supervisory Staff should direct questions concerning this report.
Christine Anderson (212) 437-5984
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Name Telephone Number (Extension)
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