Appointment of Agent for Service of Process and Undertaking (f-x)
May 29 2015 - 2:20PM
Edgar (US Regulatory)
UNITED STATES
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): Trillium Therapeutics Inc. |
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B. |
(1) |
This is (check one): |
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[X] |
An original filing for the Filer. |
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[_] |
An amended filing for the Filer. |
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(2) |
Check the following box if you are filing the
Form F-X in paper in accordance with Regulation S- T Rule 101(b)(9)
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C. |
Identify the filing in conjunction
with which this Form is being filed: |
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Name of registrant: |
Trillium Therapeutics Inc. |
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Form type: |
Form F-10 |
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File number (if known): |
333-204551 |
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Filed by: |
Trillium Therapeutics Inc. |
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Date filed (if filed concurrently, so indicate): |
May 29, 2015 (filed concurrently)
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D. |
The Filer is incorporated or organized under the laws of
Ontario, Canada and has its principal place of business at 96
Skyway Avenue, Toronto, Ontario, Canada M9W 4Y9; telephone (416)
595-0627. |
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E. |
The Filer designates and appoints Puglisi &
Associates (Agent), located at 850 Library Avenue, Suite
204, Newark, Delaware 19711; telephone (302) 738-6680 as the
agent of the Filer upon whom may be served any process, pleadings,
subpoenas, or other papers in: |
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(a) |
any investigation or administrative proceeding conducted
by the Commission; and |
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(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 any offering made or
purported to be made in connection with the securities registered or
qualified by the Filer on Form F-10 on May 29, 2015 or any
purchases or sales of any security in connection therewith. 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 the
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. |
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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 issuer of the securities to which the Form F-10 relates has
ceased reporting under the Exchange Act. |
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The Filer further undertakes to advise the Commission
promptly of any change to the Agents 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. |
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 F-10; the securities to which the
Form F-10 relates; and the transactions in such
securities. |
SIGNATURES
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 Toronto, Ontario, this
29th day of May, 2015.
TRILLIUM THERAPEUTICS INC. |
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By: |
/s/ Niclas Stiernholm |
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Name: |
Niclas Stiernholm |
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Title: |
President and Chief Executive Officer
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This statement has been signed by the following person in the
capacity indicated on May 29, 2015.
PUGLISI & ASSOCIATES |
as Agent for Service of Process for Trillium
Therapeutics Inc. |
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By: |
/s/ Donald J. Puglisi |
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Name: |
Donald J. Puglisi |
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Title: |
Managing Director
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