Appointment of Agent for Service of Process and Undertaking (f-x)
07 Mars 2023 - 12:07PM
Edgar (US Regulatory)
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UNITED STATES
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OMB APPROVAL
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SECURITIES AND EXCHANGE
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OMB Number: 3235-0379
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Washington, DC
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Expires: January 31, 2025
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Estimated average burden
hours per response:....... 2.00
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FORM F-X
APPOINTMENT OF AGENT FOR SERVICE OF
PROCESS AND UNDERTAKING
GENERAL INSTRUCTIONS
I.
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Form F-X shall be filed with the Commission:
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(a)
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By any issuer registering securities on Form F-8, F-10 or F-80
under the Securities Act of 1933;
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(b)
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By any issuer registering securities on Form 40-F under the
Securities Exchange Act of 1934;
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(c)
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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;
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(d)
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By any issuer or other non-U.S. person filing tender offer
documents on Schedule 13E-4F, 14D-1F or 14D9F;
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(e)
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By any non-U.S. person acting as trustee with respect to securities
registered on Form F-7, F-8, F-10, F80;
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(f)
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By a Canadian issuer qualifying an offering statement pursuant to
the provisions of Regulation A; and
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(g)
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By any non-U.S. issuer providing Form CB to the Commission in
connection with a tender offer, rights offering or business
combination.
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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.
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II.
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Six copies of the Form F-X, one of which must be manually signed,
shall be filed with the Commission as its principal office.
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A.
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Name of issuer or person filing (“Filer”): Avino Silver & Gold
Mines Ltd.
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B.
(1)
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This is an (check one)
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☐
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original filing for the Filer
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☐
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amended filing for the Filer |
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(2)
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Check 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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Note: Regulation S-T Rule 101(b)(9) only permits the filing of the
Form F-X in paper:
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(a)
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if the party filing or submitting the Form CB is not subject to the
reporting requirements of Section 13 or 15(d) of the Exchange Act;
or
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(b)
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if filed by a Canadian issuer when qualifying an offering statement
pursuant to the provisions of Regulation A (230.251 - 230.263 of
this chapter).
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(3)
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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.
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C.
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Identify the filing in conjunction with which this Form is being
filed:
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Name of registrant Avino Silver & Gold Mines Ltd.
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Form type Form F-10
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File Number (if known)
333-270315
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Filed by Avino Silver & Gold Mines
Ltd.___________________________________________________
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Date Filed Concurrently (filed concurrently, so
indicate)
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SEC 2288 (1-13)
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Persons who respond to the collection of information contained in
this form are not to respond unless the form displays a currently
valid OMB control
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D.
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The Filer is incorporated or organized under the laws of British
Columbia, Canada_____________________________________
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(jurisdiction name under whose laws the issuer is
organized/incorporated)
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and has its principal place of business at 570 Granville
Street, Suite 900 Vancouver, British Columbia V6C
3P1, Canada 604-682-3701
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(full
address) (telephone
number)
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E.
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The Filer designates and appoints National Registered Agents,
Inc.________ (“Agent”) located at
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(name
of United States person serving as agent)
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1015 15th Street N.W., Suite 1000 Washington, D.C.
20005
202-572-3133 as the agent of the Filer
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(full United States
address)
(telephone
number)
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upon whom may be served any process, pleadings, subpoenas, or other
papers in
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(a)
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any investigation or administrative proceeding conducted by the
Commission; and
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(b)
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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
F-10
on March _6_,
2023 or any
purchases or sales of any security in connection
(form
name)
(date)
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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.
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F.
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Each person filing this Form in connection with:
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(a)
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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;
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(b)
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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;
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(c)
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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
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(d)
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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.
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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.
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G.
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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 relate; and
the transactions in such securities.
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The Filer certifies that it has duly caused this power of attorney,
consent, stipulation and agreement to be signed
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on its behalf by the undersigned, thereunto duly authorized, in the
City of Vancouver
Country of British Columbia,
Canada 6th
this March
day of March. 2023.
(country
name)
(day of month)
(month) (year)
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Filer: Avino Silver & Gold Mines
Ltd.
by /s/ Nathan Harte, Chief Financial
Officer
(filer’s
name)
(signature and title)
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This statement has been signed by the following persons in the
capacities and on the dates indicated.
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National Registered Agents, Inc.
(as Agent for Service of Process)
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/s/ Dena Weaver
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March 1, 2023
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(signature)
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(date)
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Assistant Secretary
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(title)
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Instructions
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1.
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The power of attorney, consent, stipulation and agreement shall be
signed by the Filer and its authorized Agent in the United
States.
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2.
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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.
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