UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

FORM F-X

APPOINTMENT OF AGENT FOR SERVICE OF 

PROCESS AND UNDERTAKING 

GENERAL INSTRUCTIONS

I. Form F-X shall be filed with the Commission:

(a) By any issuer registering securities on Form F-8, F-10 or F-80 under the Securities Act of 1933;

(b) By any issuer registering securities on Form 40-F under the Securities Exchange Act of 1934;

(c) By any issuer filing a periodic report on Form 40-F, if it has not previously filed a Form F-X in connection with

the class of securities in relation to which the obligation to file a report on Form 40-F arises;

(d) By any issuer or other non-U.S. person filing tender offer documents on Schedule 13E-4F, 14D-1F or 14D9F;

(e) By any non-U.S. person acting as trustee with respect to securities registered on Form F-7, F-8, F-10, F80;

(f) By a Canadian issuer qualifying an offering statement pursuant to the provisions of Regulation A; and

(g) By any non-U.S. issuer providing Form CB to the Commission in connection with a tender offer, right soffering

or business combination.

A Form F-X filed in connection with any other Commission form should no be bound together with or be included

only as an exhibit to, such other form.

II. A filer must file the Form F-X in electronic format via the Commission’s Electronic Data Gathering, Analysis, and

Retrieval (EDGAR) system in accordance with the EDGAR rules set forth in Regulation S-T (17 CFR part 232).

For assistance with EDGAR issues, please consult the EDGAR – Information for Filers webpage on SEC.gov.

A. Name of issuer or person filing (“Filer”): ________________________________________________________

B.(1)	 This is an (check one)

original filing for the Filer

amended filing for the Filer

(2) A filer may also file the Form F-X in paper under a hardship exemption provided by Regulation S-T Rule

201 or 202 (17 CFR 232.201 or 232.202). When submitting the Form F-X in paper under a hardship

exemption, a filer must provide the legend required by Regulation S-T Rule 201(a)(2) or 202(c) (17 CFR

232.201(a)(2) or 232.202(c)) on the cover page of the Form F-X.

C. Identify the filing in conjunction with which this Form is being filed:

Name of registrant ______________________________________________________

Form type _____________________________________________________________

File Number (if known) ___________________________________________________

Filed by _______________________________________________________________

Date Filed ______________________ (if filed concurrently, so indicate)

D. The Filer is incorporated or organized under the laws of ____________________________________________

and has its principal place of business at __________________________________________ ____________

E. The Filer designates and appoints __________________________________ (“Agent”) located at

______________________________________________________ _____________	 as the agent of the Filer

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(date)

(jurisdiction name under whose laws the issuer is organized/incorporated)

(telephone number)

(telephone number)

(full address)

(name of United States person serving as agent)

(full United States address)
upon whom may be served any process, pleadings, subpoenas, or other papers in

(a)	 any investigation or administrative proceeding conducted by the Commission; and

(b)	 any civil suit or action brought against the Filer or to which the Filer has been joined as defendant or

respondent, in any appropriate court in any place subject to the jurisdiction of any state or of the United

States or of any of its territories or possessions or of the District of Columbia, where the investigation,

proceeding or cause of action arises out of or relates to or concerns (i) any offering made or purported

to be made in connection with the securities registered or qualified by the Filer on Form

___________________ on __________________ or any purchases or sales of any security in connection

therewith; (ii) the securities in relation to which the obligation to file an annual report on Form 40-F arises,

or any purchases or sales of such securities; (iii) any tender offer for the securities of a Canadian issuer

with respect to which filings are made by the Filer with the Commission on Schedule 13E-4F, 14D-1F or

14D-9F; or (iv) the securities in relation to which the Filer acts as trustee pursuant to an exemption under

Rule 10a-5 under the Trust Indenture Act of 1939. The Filer stipulates and agrees that any such civil suit

or action or administrative proceeding may be commenced by the service of process upon, and that service

of an administrative subpoena shall be effected by service upon such agent for service of process, and

that service as aforesaid shall be taken and held in all courts and administrative tribunals to be valid and

binding as if personal service thereof had been made.

F.	 Each person filing this Form in connection with:

(a)	 the use of Form F-10, 40-F or Schedule 13E-4F, 14D-1F or 14D-9F stipulates and agrees to appoint a

successor agent for service of process and file an amended Form F-X if the Filer discharges the Agent or

the Agent is unwilling or unable to accept service on behalf of the Filer at any time until six years have

elapsed from the date the issuer of the securities to which such Forms and Schedules relate has ceased

reporting under the Exchange Act;

(b)	 the use of Form F-8, Form F-80 or Form CB stipulates and agrees to appoint a successor agent for service

of process and file an amended Form F-X if the Filer discharges the Agent or the Agent is unwilling

or unable to accept service on behalf of the Filer at any time until six years have elapsed following the

effective date of the latest amendment to such Form F-8, Form F-80 or Form CB;

(c)	 its status as trustee with respect to securities registered on Form F-7, F-8, F-10, F-80 stipulates and agrees

to appoint a successor agent for service of process and file an amended Form F-X if the Filer discharges the

Agent or the Agent is unwilling or unable to accept service on behalf of the Filer at any time during which

any of the securities subject to the indenture remain outstanding; and

(d)	 the use of Form 1-A or other Commission form for an offering pursuant to Regulation A stipulates and

agrees to appoint a successor agent for service of process and file an amended Form F-X if the Filer

discharges the Agent or the Agent is unwilling or unable to accept service on behalf of the Filer at any time

until six years have elapsed from the date of the last sale of securities in reliance upon the Regulation A

exemption.

Each filer further undertakes to advise the Commission promptly of any change to the Agent’s name or address

during the applicable period by amendment of this Form, referencing the file number of the relevant form in

conjunction with which the amendment is being filed.

G.	 Each person filing this Form, other than a trustee filing in accordance with General Instruction I. (a) of this 

Form, undertakes to make available, in person or by telephone, representatives to respond to inquiries made by

the Commission staff, and to furnish promptly, when requested to do so by the Commission staff, information

relating to: the Forms, Schedules and offering statements described in General Instructions I. (a), I. (b), I. (c), I.

(d) and I. (f) of this Form, as applicable; the securities to which such Forms, Schedules and offering statements

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(form name) (date)
relate; and the transactions in such securities.

The Filer certifies that it has duly caused this power of attorney, consent, stipulation and agreement to be signed

on its behalf by the undersigned, thereunto duly authorized, in the City of ______________________________

Country of ______________________________________ 	this _______ day of ______________, _______.

Filer: __________________________________________ by ______________________________________

This statement has been signed by the following persons in the capacities and on the dates indicated.

_______________________________________________ __________________

_______________________________________________

(day of month) (month) (year)

(signature and title)

(signature)

(title)

(filer’s name)

(city name)

(country name)

(date)

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Instructions

1.	 The power of attorney, consent, stipulation and agreement shall be signed by the Filer and its

authorized Agent in the United States.

2.	 The name of each person who signs Form F-X shall be typed or printed beneath such person’s

signature. Any person who occupies more than one of the specified positions shall indicate each

capacity in which such person signs Form F-X. If any name is signed pursuant to a board resolution,

a copy of the resolution shall be filed with each copy of Form F-X. A certified copy of such resolution

shall be filed with the manually signed copy of Form F-X. If any name is signed pursuant to a power

of attorney, a copy of the power of attorney shall be filed with each copy of Form F-X. A manually

signed copy of such power of attorney shall be filed with the manually signed copy of Form F-X.