Appointment of Agent for Service of Process and Undertaking (f-x)
July 13 2021 - 5:25PM
Edgar (US Regulatory)
U.S.
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Appointment
of Agent For Service
of Process And Undertaking
|
A.
|
Name
of issuer or person filing (the "Filer"): GREENBROOK
TMS INC.
|
B.
|
(1)
|
This
is [check one]:
|
|
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 Registrants:
|
Greenbrook TMS Inc.
|
|
Form Type:
|
Registration Statement
on Form F-10
|
|
File Number (if known):
|
333-257872
|
|
Filed by:
|
Greenbrook TMS Inc.
|
|
Date Filed (if filed concurrently,
so indicate):
|
July 13, 2021 (filed
concurrently)
|
|
D.
|
Filer
is incorporated or organized under the laws of Ontario, Canada and has its principal
place of business at
|
890 Yonge Street
7th Floor
Toronto, Ontario, Canada
M4W 314
(telephone: (416) 915-9100).
|
E.
|
The
Filer designates and appoints TMS NeuroHealth Centers Inc. (the "Agent"),
located at
|
8401 Greensboro Drive, Suite 425
Tysons Corner, Virginia 22102
(telephone: (416) 322-9700)
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 the date hereof (the "Form F-10")
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 service of an administrative subpoena shall be effected
by service upon such agent for service of process, and that the 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 such forms and schedules relate 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.
|
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, thereto duly authorized, in
Toronto, Canada, on July 13, 2021.
Filer:
|
GREENBROOK TMS INC.
|
|
|
|
By:
|
/s/ Bill Leonard
|
|
|
Name:
|
Bill Leonard
|
|
|
Title:
|
Chief Executive Officer
|
This statement has been signed by the following person in the capacity
and on the date indicated:
|
TMS NEUROHEALTH CENTERS INC.
|
|
|
|
By:
|
/s/ Bill Leonard
|
|
|
Name:
|
Bill Leonard
|
|
|
Title:
|
President
|
Greenbrook TMS (NASDAQ:GBNH)
Historical Stock Chart
From Mar 2024 to Apr 2024
Greenbrook TMS (NASDAQ:GBNH)
Historical Stock Chart
From Apr 2023 to Apr 2024