Statement of Changes in Beneficial Ownership (4)
September 01 2022 - 01:00PM
Edgar (US Regulatory)
FORM 4
[ ] 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 * Liang Philip |
2. Issuer Name and Ticker or Trading
Symbol Vicarious Surgical Inc. [ RBOT ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
|
(Last)
(First)
(Middle)
C/O VICARIOUS SURGICAL INC., 78 FOURTH AVENUE |
3. Date of Earliest Transaction (MM/DD/YYYY)
8/30/2022
|
(Street)
WALTHAM, MA 02451
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
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 |
8/30/2022 |
|
J(1) |
|
30000 |
D |
$0 |
300001 |
I |
By E15 Fund Advisors (HK)
Limited (2) |
Class A Common Stock |
|
|
|
|
|
|
|
43888 |
I |
By Chelvey International
Limited (3) |
Class A Common Stock |
|
|
|
|
|
|
|
1242377 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
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) |
E15 Fund Advisors (HK)
Limited distributed these shares to its members on a pro rata
basis, for no consideration. |
(2) |
Shares held directly by E15
Fund Advisors (HK) Limited. The Reporting Person, as the managing
partner of E15 Fund Advisors (HK) Limited, may be deemed to share
voting and dispositive power over the shares held by E15 Fund
Advisors (HK) Limited. The Reporting Person disclaims beneficial
ownership of shares held by E15 Fund Advisors (HK) Limited, except
to the extent of any pecuniary interest therein. |
(3) |
Shares held directly by
Chelvey International Limited. E15 Fund II, LP, the sole
shareholder of Chelvey International Limited, may be deemed to have
sole voting and dispositive power over the shares held by Chelvey
International Limited. The Reporting Person, as the managing
partner of E15 Fund II, LP, may be deemed to share voting and
dispositive power over the shares held by E15 Fund II, LP. The
Reporting Person disclaims beneficial ownership of shares held by
E15 Fund II, LP, except to the extent of any pecuniary interest
therein. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Liang Philip
C/O VICARIOUS SURGICAL INC.
78 FOURTH AVENUE
WALTHAM, MA 02451 |
X |
|
|
|
Signatures
|
/s/ June Morris, Attorney-in-Fact |
|
9/1/2022 |
**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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