-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, SWLDxufNoKrYe1Kvnn1VzsfddYhEFbr0/6wa7fStIMVDVELz+o4ik7i6oDA6Ks2L St4k6zIdhLlpzzUg+64JTA== 0000819996-04-000008.txt : 20040315 0000819996-04-000008.hdr.sgml : 20040315 20040312185032 ACCESSION NUMBER: 0000819996-04-000008 CONFORMED SUBMISSION TYPE: 40-F/A PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040315 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PLACER DOME INC CENTRAL INDEX KEY: 0000819996 STANDARD INDUSTRIAL CLASSIFICATION: GOLD & SILVER ORES [1040] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 40-F/A SEC ACT: 1934 Act SEC FILE NUMBER: 333-105126 FILM NUMBER: 04667387 BUSINESS ADDRESS: STREET 1: 1055 DUNSMUIR ST STE 1600 STREET 2: PO BOX 49330 BENTALL POSTAL STATION CITY: VANCOUVER BC CANADA STATE: A1 BUSINESS PHONE: 6046827082 MAIL ADDRESS: STREET 1: 1600-1055 DUNSMUIR ST STREET 2: PO BOX 49330 BENTALL STATION CITY: VANCOUVER STATE: A1 ZIP: V7X1P1 40-F/A 1 form40-fa.htm FORM 40-F/A

U.S. SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

FORM 40 – F/A

[   ]     Registration statement pursuant to Section 12 of the Securities Exchange Act of 1934.

[X]     Annual report pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934.

For the Fiscal Year Ended: December 31, 2003                      Commission File Number 1-9662

PLACER DOME INC.
Canada
(Jurisdiction of incorporation or
organization)

Suite 1600, 1055 Dunsmuir Street
P.O. Box 49330, Bentall Postal Stn.
Vancouver, British Columbia
Canada V7X 1P1
Telephone: (604) 682-7082
(Registrant's Principal Executive Offices)
1041
(Primary Standard Industrial
Classification Code Number)
Not Applicable
(I.R.S. Employer Identification Number)

Robert M. Riggs
Carter Ledyard & Milburn LLP
2 Wall Street
New York, New York
10005-2072
Telephone: (212) 732-3200
(Agent for Service in the United States)

        Securities registered pursuant to Section 12(b) of the Act:

        Title of Each Class:                  Name of Each Exchange on Which Registered:

Common Shares

New York Stock Exchange
Toronto Stock Exchange
Australian Stock Exchange
Euronext-Paris
Swiss Exchange
 
Common Share
   Purchase Rights
New York Stock Exchange
Toronto Stock Exchange

Securities registered or to be registered pursuant to Section 12(g) of the Act: None

Securities for which there is a reporting obligation pursuant to Section 15(d) of the Act: None

For annual reports, indicate by check mark the information filed with this Form:
|X|     Annual Information Form         |X|     Audited Annual Financial Statements

At December 31, 2003, 411,530,294 Common Shares of the Registrant were outstanding.

Indicate by check mark whether the Registrant by filing the information in this form is also thereby furnishing the information to the Commission pursuant to Rule 12g3-2(b) under the Securities Exchange Act of 1934 (the “Exchange Act”). If “Yes” is marked, indicate the file number assigned to the registrant in connection with such Rule.    Yes         No |X|

Indicate by check mark whether the Registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Exchange Act during the preceding 12 months (or for such shorter period that the Registrant was required to file such reports); and (2) has been subject to such filing requirements for the past 90 days.

Yes |X|    No   


INTRODUCTORY NOTE

By this Amendment No. 1 on Form 40-F/A to its Annual Report on Form 40-F filed on March 5, 2004, the Registrant is correcting certain inadvertent typographical errors on page 169 of the Renewal Annual Information Form filed as Document 1 in its Annual Report on Form 40-F as follows:

Clifford L. Michel
Gladstone, New Jersey, USA
(4)
1987   Senior Counsel, Cahill Gordon & Reindel LLP (law firm)
since February 2001, and prior thereto, Partner; President
and CEO and a director of Wenonah Development Company
(private investment company), President and CEO,
HomeWinds Foundation; Trustee of a complex of mutual
funds managed by Alliance Capital Management; Trustee of
St. Mark's School; Treasurer of Jockey Hollow Foundation.

UNDERTAKING AND CONSENT TO SERVICE OF PROCESS

Undertaking

The Registrant undertakes to make available, in person or by telephone, representatives to respond to inquiries made by the Securities and Exchange Commission (“SEC”) staff, and to furnish promptly, when requested to do so by the SEC staff, information relating to: the securities registered pursuant to Form 40-F; the securities in relation to which the obligation to file an annual report on Form 40-F arises; or transactions in said securities.

Consent to Service of Process

Consent to Service of Process on Form F-X in connection with the Common Shares has been previously filed with the SEC.

SIGNATURES

Pursuant to the requirements of the Exchange Act, the Registrant certifies that it meets all of the requirements for filing on Form 40-F and has duly caused this Amendment No. 1 to the annual report to be signed on its behalf by the undersigned, thereto duly authorized.

PLACER DOME INC.
Registrant



"J. Donald Rose"

J. Donald Rose
Executive Vice-President, Secretary and General Counsel
March 12, 2004

EX-31 3 exhibit31.htm CERTIFICATIONS OF CEO AND CFO

EXHIBIT 31

Certification

Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002

I, Jay K. Taylor, certify that:

1)

I have reviewed this Amendment No. 1 to the annual report on Form 40-F/A of Placer Dome Inc.; and


2)

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report.


Date: March 12, 2004



"Jay K. Taylor"

Name: Jay K. Taylor
Title: Chief Executive Officer and President, Placer Dome Inc.


Certification

Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002

I, Rex J. McLennan, certify that:

1)

I have reviewed this Amendment No. 1 to the annual report on Form 40-F/A of Placer Dome Inc.; and


2)

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report.


Date: March 12, 2004



"Rex J. McLennan"

Name: Rex J. McLennan
Title: Chief Financial Officer and Executive-Vice President, Placer Dome Inc.

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