SEC Form F-3 filed by MEDIROM Healthcare Technologies Inc.
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
UNDER
THE SECURITIES ACT OF 1933
(Exact name of Registrant as specified in its charter)
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Japan
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Not Applicable
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(State or other jurisdiction of
incorporation or organization) |
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(I.R.S. Employer
Identification Number) |
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Minato-ku
Tokyo 135-0091, Japan
+81-(0)3-6721-7364
122 East 42nd Street, 18th Floor
New York, NY 10168
800-221-0102
(Name, address, and telephone number of agent for service)
John Stapleton
Loeb & Loeb LLP
345 Park Avenue
New York, NY 10154
Telephone: (212) 407-4000
Facsimile: (212) 407-4990
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Persons depositing or withdrawing common shares or ADS holders
must pay: |
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For:
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| $5.00 (or less) per 100 ADSs (or portion of 100 ADSs) | | |
Issuance of ADSs, including issuances resulting from a distribution of shares or rights or other property
Cancellation of ADSs for the purpose of withdrawal, including if the deposit agreement terminates
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| $.05 (or less) per ADS | | | Any cash distribution to ADS holders | |
| A fee equivalent to the fee that would be payable if securities distributed to you had been Common Shares and the Common Shares had been deposited for issuance of ADSs | | | Distribution of securities distributed to holders of deposited securities (including rights) that are distributed by the depositary to ADS holders | |
| $.05 (or less) per ADS per calendar year | | | Depositary services | |
| Registration or transfer fees | | | Transfer and registration of shares on our share register to or from the name of the depositary or its agent when you deposit or withdraw shares | |
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Persons depositing or withdrawing common shares or ADS holders
must pay: |
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For:
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| Expenses of the depositary | | |
Cable (including SWIFT) and facsimile transmissions (when expressly provided in the deposit agreement)
Converting foreign currency to U.S. dollars
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| Taxes and other governmental charges the depositary or the custodian has to pay on any ADSs or Common Shares underlying ADSs, such as stock transfer taxes, stamp duty or withholding taxes | | | As necessary | |
| Any charges incurred by the depositary or its agents for servicing the deposited securities | | | As necessary | |
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SEC registration fee
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| | | $ | 7,655 | | |
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FINRA fees
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| | | $ | 8,000 | | |
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Legal fees and expenses
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| | | $ | * | | |
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Accounting fees and expenses
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| | | $ | * | | |
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Printing expenses
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| | | $ | * | | |
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Miscellaneous expenses
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| | | $ | * | | |
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Total
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| | | $ | * | | |
2-3-1 Daiba,
Minato-ku
Tokyo 135-0091, Japan
+81-(0)3-6721-7364
| | By: | | |
/s/ Kouji Eguchi
Kouji Eguchi
Chief Executive Officer (Principal Executive Officer) |
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Signature
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Title
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Date
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/s/ Kouji Eguchi
Name: Kouji Eguchi
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Chief Executive Officer and Representative Director
(Principal Executive Officer) |
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September 10, 2025
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/s/ Fumitoshi Fujiwara
Name: Fumitoshi Fujiwara
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Chief Financial Officer and Director
(Principal Financial and Accounting Officer) |
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September 10, 2025
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/s/ Akira Nojima
Name: Akira Nojima
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| | Independent Director | | |
September 10, 2025
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/s/ Tomoya Ogawa
Name: Tomoya Ogawa
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| | Independent Director | | |
September 10, 2025
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Authorized U.S. Representative
| | By: | | |
/s/ Colleen A. De Vries
Name: Colleen A. De Vries
Title:
Senior Vice President on behalf of Cogency Global Inc.
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