F-X
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM F-X
APPOINTMENT OF AGENT FOR SERVICE OF PROCESS
AND UNDERTAKING
A. Name of issuer or person filing (Filer): Theratechnologies Inc.
B. This is [check one]:
|
þ |
|
an original filing for the Filer. |
|
|
o |
|
an amended filing for the Filer. |
C. Identify the filing in conjunction with which this form is being filed:
|
|
|
|
|
|
|
Name of registrant:
|
|
Theratechnologies Inc. |
|
|
|
|
|
|
|
Form type:
|
|
Registration Statement on Form 40-F (the Form 40-F) |
|
|
|
|
|
|
|
File number (if known):
|
|
333-172378 |
|
|
|
|
|
|
|
Filed by:
|
|
Theratechnologies Inc. |
|
|
|
|
|
|
|
Date filed (if filed concurrently, so indicate):
|
|
June 13, 2011
(concurrent with filing of Form 40-F) |
D. The Filer is incorporated or organized under the laws of
|
|
|
|
|
|
|
|
|
Québec, Canada |
|
|
|
|
|
|
|
and has its principal place of business at |
|
|
|
|
|
|
|
|
|
Theratechnologies Inc. |
|
|
|
|
2310 Alfred-Nobel Boulevard |
|
|
|
|
Montreal, Québec, Canada |
|
|
|
|
H4S 2B4 |
E. The Filer designates and appoints CT Corporation System (the Agent), located at:
111 8th Avenue
New York, NY 10011
Telephone: (212) 894-8800
|
|
as the agent of the Filer 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 40-F on June 13, 2011 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. The Filer 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 Filer has
ceased reporting under the Securities Exchange Act of 1934, as amended. The Filer further
undertakes to advise the Commission promptly of any change to the Agents name and address during
such period by amendment of this Form, referencing the file number of the relevant form in
conjunction with which the amendment is being filed.
G. The Filer 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 Form 40-F; the securities to which the Form 40-F
relates; 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
Montreal, Province of Québec, Canada, this
13th day of June, 2011.
|
|
|
|
|
|
|
Theratechnologies Inc.
|
|
By: |
|
/s/ Jocelyn Lafond |
|
|
|
|
|
|
Name: Jocelyn Lafond
|
|
|
|
|
|
|
Title: Vice President, Legal Affairs |
|
|
This statement has been signed by the following person and in the capacities and on the dates
indicated:
|
|
|
|
|
|
|
|
|
|
|
CT CORPORATION SYSTEM, as Agent for Service of Process for
Theratechnologies Inc. |
|
|
|
|
|
|
|
|
|
|
|
By:
|
|
/s/ Robert OByrne
Name: Robert OByrne
|
|
|
|
|
|
|
Title: Assistant Secretary |
|
|
|
|
|
|
Date: June 13, 2011 |
|
|
2