SEC-2560 Form CB

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

OMB APPROVAL
OMB Number:
3235-0518
Expires:
January 31, 2024
Estimated average burden
hours per response
0.5

Form CB
TENDER OFFER/RIGHTS OFFERING NOTIFICATION FORM
(AMENDMENT NO. ______)
Please place an X in the box(es) to designate the appropriate rule provision(s) relied upon to file this Form:
Securities Act Rule 801 (Rights Offering)
[
Securities Act Rule 802 (Exchange Offer)
[
Exchange Act Rule 13e-4(h)(8) (Issuer Tender Offer)
[
Exchange Act Rule 14d-1(c) (Third Party Tender Offer)
[
Exchange Act Rule 14e-2(d) (Subject Company Response) [

]
]
]
]
]

(Name of Subject Company)
(Translation of Subject Company’s Name into English (if applicable))
(Jurisdiction of Subject Company’s Incorporation or Organization)
(Name of Person(s) Furnishing Form)
(Title of Class of Subject Securities)
(CUSIP Number of Class of Securities (if applicable))
(Name, Address (including zip code) and Telephone Number (including area code) of
Person(s) Authorized to Receive Notices and Communications on Behalf of Subject Company)
(Date Tender Offer/Rights Offering Commenced)

* An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid control number. Any member of the public may direct to
the Commission any comments concerning the accuracy of this burden estimate and any suggestions for
reducing this burden. This collection of information has been reviewed by OMB in accordance with the
clearance requirements of 44 U.S.C. 3507.

SEC 2560 (07-22)

Persons who respond to the collection of information contained in the form are
not required to respond unless the fomr displays a current valid OMB control number.

GENERAL INSTRUCTIONS
I.

Eligibility Requirements for Use of Form CB
A. Use this Form to furnish information pursuant to Rules 13e-4(h)(8), 14d-1(c) and 14e-2(d) under the
Securities Exchange Act of 1934 (“Exchange Act”), and Rules 801 and 802 under the Securities Act of
1933 (“Securities Act”).
Instructions
1. For the purposes of this Form, the term “subject company” means the issuer of the securities in a rights
offering and the company whose securities are sought in a tender offer.
2. For the purposes of this Form, the term “tender offer” includes both cash and securities tender offers.
B. The information and documents furnished on this Form are not deemed “filed” with the Commission or
otherwise subject to the liabilities of Section 18 of the Exchange Act.

II. Instructions for Submitting Form
A. (1) Regulation S-T Rule 101(a)(1)(vi) (17 CFR 232.101(a)(1)(vi)) requires a party to submit the Form CB in
electronic format via the Commission’s Electronic Data Gathering and Retrieval system (EDGAR) in
accordance with the EDGAR rules set forth in Regulation S-T (17 CFR Part 232). For assistance with
technical questions about EDGAR or to request an access code, call the EDGAR Filer Support Office
at (202) 551-8900.
(2) A party may also file a Form CB in paper under a hardship exemption provided by Regulation S-T
Rule 201 or 202 (17 CFR 232.201 or 232.202). When submitting a Form CB in paper under a
hardship exemption, a party 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 CB.
(3) If filing the Form CB in paper in accordance with a hardship exemption, you must furnish five copies
of this Form and any amendment to the Form (see Part I, Item 1.(b)), including all exhibits and any
other paper or document furnished as part of the Form, to the Commission at its principal office. You
must bind, staple or otherwise compile each copy in one or more parts without stiff covers. You must
make the binding on the side or stitching margin in a manner that leaves the reading matter legible.
B. When submitting the Form CB in electronic format, the persons specified in Part IV must provide
signatures in accordance with Regulation S-T Rule 302 (17 CFR 232.302). When submitting the Form CB
in paper, the persons specified in Part IV must sign the original and at least one copy of the Form and
any amendments. You must conform any unsigned copies. The specified persons may provide typed or
facsimile signatures in accordance with Securities Act Rule 402(e) (17 CFR 230.402(e)) or Exchange Act
Rule 12b-11(d) (17 CFR 240.12b-11(d)) as long as the filer retains copies of signatures manually signed
by each of the specified persons for five years.

C. You must furnish this Form to the Commission no later than the next business day after the disclosure
documents submitted with this Form are published or otherwise disseminated in the subject company’s
home jurisdiction.

2

D. If filing in paper, in addition to any internal numbering you may include, sequentially number the signed
original of the Form and any amendments by handwritten, typed, printed or other legible form of
notation from the first page of the document through the last page of the document and any exhibits or
attachments. Further, you must set forth the total number of pages contained in a numbered original on
the first page of the document.
III. Special Instructions for Complying with Form CB
Under Sections 3(b), 7, 8, 10, 19 and 28 of the Securities Act of 1933, and Sections 12, 13, 14, 23 and 36
of the Exchange Act of 1934 and the rules and regulations adopted under those Sections, the Commission is
authorized to solicit the information required to be supplied by this form by certain entities conducting a tender
offer, rights offer or business combination for the securities of certain issuers.
Disclosure of the information specified in this form is mandatory. We will use the information for the
primary purposes of assuring that the offeror is entitled to use the Form and that investors have information
about the transaction to enable them to make informed investment decisions. We will make this Form a matter of
public record. Therefore, any information given will be available for inspection by any member of the public.
Because of the public nature of the information, the Commission can use it for a variety of purposes. These
purposes include referral to other governmental authorities or securities self-regulatory organizations for
investigatory purposes or in connection with litigation involving the Federal securities laws or other civil,
criminal or regulatory statutes or provisions.
PART I - INFORMATION SENT TO SECURITY HOLDERS
Item 1. Home Jurisdiction Documents
(a) You must attach to this Form the entire disclosure document or documents, including any amendments
thereto, in English, that you have delivered to holders of securities or published in the subject
company’s home jurisdiction that are required to be disseminated to U.S. security holders or published
in the United States. The Form need not include any documents incorporated by reference into those
disclosure document(s) and not published or distributed to holders of securities.
(b) Furnish any amendment to a furnished document or documents to the Commission under cover of this
Form. Indicate on the cover page the number of the amendment.

Item 2. Informational Legends
You may need to include legends on the outside cover page of any offering document(s) used in the
transaction. See Rules 801(b) and 802(b).
Note to Item 2. If you deliver the home jurisdiction document(s) through an electronic medium, the required
legends must be presented in a manner reasonably calculated to draw attention to them.

PART II - INFORMATION NOT REQUIRED TO BE SENT TO SECURITY HOLDERS
The exhibits specified below must be furnished as part of the Form, but need not be sent to security holders
unless sent to security holders in the home jurisdiction. Letter or number all exhibits for convenient reference.
(1) Furnish to the Commission either an English translation or English summary of any reports or information
that, in accordance with the requirements of the home jurisdiction, must be made publicly available in

3

connection with the transaction but need not be disseminated to security holders. Any English summary
submitted must meet the requirements of Regulation S-T Rule 306(a) (17 CFR 232.306(a)) if submitted
electronically or of Securities Act Rule 403(c)(3) (17 CFR 230.403(c)(3)) or Exchange Act Rule 12b12(d)(3) (17 CFR 240.12b-12(d)(3)) if submitted in paper.
(2) Furnish copies of any documents incorporated by reference into the home jurisdiction document(s).
Note to paragraphs (1) and (2) of Part II: In accordance with Regulation S-T Rule 311(f) (17 CFR
232.311(f)), a party may submit a paper copy under cover of Form SE (17 CFR 239.64, 249.444, 259.603,
269.8, and 274.403) of an unabridged foreign language document when submitting an English summary in
electronic format under paragraph (1) of this Part or when furnishing a foreign language document that has
been incorporated by reference under paragraph (2) of this Part.
(3) If any of the persons specified in Part IV has signed the Form CB under a power of attorney, a party
submitting the Form CB in electronic format must include a copy of the power of attorney signed in
accordance with Regulation S-T Rule 302 (17 CFR 232.302). A party submitting the Form CB in paper must
also include a copy of the signed power of attorney.

PART III - CONSENT TO SERVICE OF PROCESS
(1) When this Form is furnished to the Commission, the person furnishing this Form (if a non-U.S. person) must
also file with the Commission a written irrevocable consent and power of attorney on Form F-X.
(2) Promptly communicate any change in the name or address of an agent for service to the Commission by
amendment of the Form F-X.
PART IV - SIGNATURES
(1) Each person (or its authorized representative) on whose behalf the Form is submitted must sign the Form. If
a person’s authorized representative signs, and the authorized representative is someone other than an
executive officer or general partner, provide evidence of the representative’s authority with the Form.
(2) Type or print the name and any title of each person who signs the Form beneath his or her signature.
After due inquiry and to the best of my knowledge and belief, I certify that the information set forth in this
statement is true, complete and correct.

(Signature)
(Name and Title)
(Date)

4