Amended Statement of Changes in Beneficial Ownership (4/a)
03 Juni 2022 - 10:14PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Berman Dror |
2. Issuer Name and Ticker or Trading Symbol
Vicarious Surgical Inc.
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RBOT
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O VICARIOUS SURGICAL INC., 78 FOURTH AVENUE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
9/17/2021 |
(Street)
WALTHAM, MA 02451
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
9/23/2021 |
6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class A Common Stock | | | | | | | | 13770143 | I | By Innovation Endeavors III LP (1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | Shares held directly by Innovation Endeavors III LP. Innovation Endeavors III GP, LLC, the general partner of Innovation Endeavors III LP, may be deemed to have sole voting and dispositive power over the shares held by Innovation Endeavors III LP. The Reporting Person, as a manager of Innovation Endeavors III GP, LLC and may be deemed to share voting and dispositive power over the shares held by Innovation Endeavors III LP. The Reporting Person disclaims beneficial ownership of shares held by Innovation Endeavors III LP, except to the extent of any pecuniary interest therein. |
Remarks: This Form 4 amendment is being filed to include the 333,333 shares of Class A common stock purchased by Innovation Endeavors III LP from Vicarious Surgical Inc., at a price of $10.00 per share, in a private placement immediately prior to the closing of the transactions contemplated by the Agreement and Plan of Merger, dated as of April 15, 2021, by and among D8 Holdings Corp. ("D8"), Snowball Merger Sub, Inc., a Delaware corporation and wholly owned subsidiary of D8 ("Merger Sub"), and Vicarious Surgical Inc., a Delaware corporation, pursuant to which Merger Sub merged with and into Vicarious Surgical Inc., with Vicarious Surgical Inc. surviving as a wholly-owned subsidiary of D8 (which changed its name to "Vicarious Surgical Inc."). This Form 4 amendment is intended to replace, in its entirety, the Form 4 filed on September 23, 2021. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Berman Dror C/O VICARIOUS SURGICAL INC. 78 FOURTH AVENUE WALTHAM, MA 02451 | X | X |
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Signatures
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/s/ June Morris, Attorney-in-Fact | | 6/3/2022 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
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