Statement of Changes in Beneficial Ownership (4)
July 15 2022 - 04:34PM
Edgar (US Regulatory)
FORM 4
[X] 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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OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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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 * CHU DAVID |
2. Issuer Name and Ticker or Trading
Symbol Vicarious Surgical Inc. [ RBOT ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director __X__
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
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(Last)
(First)
(Middle)
SUITE 2810-12, ONE PACIFIC PLACE, 88 QUEENSWAY |
3. Date of Earliest Transaction (MM/DD/YYYY)
7/13/2022
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(Street)
ADMIRALTY, K3 00000
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Class A common stock, par value $0.0001 per
share |
7/13/2022 |
|
J(1)(3) |
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8535000 |
D |
(1) |
0 (1) |
I |
See Footnote (1) |
Class A common stock, par value $0.0001 per
share |
7/13/2022 |
|
J(2)(3) |
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815446 |
A |
(2) |
815446 (2) |
D |
|
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) |
D8 Sponsor LLC was the
record holder of the securities reported herein. David Chu is one
of the two managers of D8 Sponsor LLC and shared voting and
investment discretion with respect to the shares of Class A common
stock held of record by D8 Sponsor LLC. Mr. Chu disclaimed any
beneficial ownership of the securities held by D8 Sponsor LLC other
than to the extent of any pecuniary interest he may have therein,
directly or indirectly. D8 Sponsor LLC distributed 100% of the
issued and outstanding shares of Class A common stock of the Issuer
held by it to its members in accordance with the terms of its
limited liability company agreement. |
(2) |
D8 Sponsor LLC distributed
815,446 shares of Class A common stock of the Issuer to Mr. Chu in
his capacity as a member of D8 Sponsor LLC. Mr. Chu is not a
director, officer or 10% Owner. Accordingly, he is no longer
subject to Section 16 of the Securities Exchange Act of
1934. |
(3) |
Under Rule 16a-13
promulgated under the Securities Exchange Act of 1934, as a change
in form of beneficial ownership, the reported distribution by D8
Sponsor LLC to its members, and the reported acquisition by Mr. Chu
from D8 Sponsor LLC, were exempt from Section 16 of the Securities
Exchange Act of 1934. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
CHU DAVID
SUITE 2810-12, ONE PACIFIC PLACE
88 QUEENSWAY
ADMIRALTY, K3 00000 |
|
X |
|
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Signatures
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/s/ Audrey Bae, as
Attorney-in-Fact |
|
7/15/2022 |
**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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