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”): BELLUS Health Inc.
   
B. (1) This is:
     
  x an original filing for the Filer.
     
  ¨  an amended filing for the Filer.
     
  (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) ¨
     
C. Identify the filing in conjunction with which this Form is being filed:

 

  Name of registrant: BELLUS Health Inc.
  Form type: Form F-10
  File number (if known): 333-251329
  Filed by: BELLUS Health Inc.
  Date filed (if filed concurrently, so indicate): December 14, 2020, concurrently herewith

 

D. The Filer is incorporated or organized under the laws of  Canada and has its principal place of business at 275 Armand-Frappier Boulevard, Laval, Quebec H7V 4A7, Canada, telephone number: (450) 680-4525.
     
E. The Filer designates and appoints C T Corporation System (“Agent”), located at 1015 15th Street, NW, Suite 1000, Washington, District of Columbia 20005 telephone number (202) 572-3111, 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 any offering made or purported to be made in connection with the securities registered or qualified by the Filer on Form F-10 on December 14, 2020 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.

 

 

 

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.
     
  The 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. 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 the City of Laval, Quebec, Country of Canada on December 14th, 2020.

 

  BELLUS HEALTH INC.  
       
 

By:

/s/ Roberto Bellini  
  Name: Roberto Bellini  
  Title: President and Chief Executive Officer  
       

 

 

 

 

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

 

 

C T CORPORATION SYSTEM

(as Agent for Service of Process)

 
       
 

By:

/s/ Olga Hinkel  
  Name: Olga Hinkel  
  Title: Vice President & Assistant Secretary  
  Date: December 14, 2020  
       

 

 

 

 

BELLUS Health (NASDAQ:BLU)
Historical Stock Chart
From Mar 2024 to Apr 2024 Click Here for more BELLUS Health Charts.
BELLUS Health (NASDAQ:BLU)
Historical Stock Chart
From Apr 2023 to Apr 2024 Click Here for more BELLUS Health Charts.