Statement of Changes in Beneficial Ownership (4)
April 11 2023 - 1:46PM
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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OMB APPROVAL
OMB Number:
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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Liang Philip |
2. Issuer Name and Ticker or Trading Symbol
Vicarious Surgical Inc.
[
RBOT
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 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)
4/10/2023 |
(Street)
WALTHAM, MA 02451 |
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
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(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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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 | 4/10/2023 | | P(1) | | 5925 | A | $2.20 | 5925 | I | By E15 Fund III, LP (2) |
Class A Common Stock | | | | | | | | 43888 | I | By Chelvey International Limited (3) |
Class A Common Stock | | | | | | | | 330001 | I | By E15 Fund Advisors (HK) Limited (4) |
Class A Common Stock | | | | | | | | 1153019 | 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) | The Reporting Person's purchase of the Issuer's Class A common stock reported herein was matchable under Section 16(b) of the Securities Exchange Act of 1934, as amended. The Reporting Person has agreed to pay to the Issuer, upon confirmation of settlement of the transaction, the full amount of the profit realized in connection with the transaction. |
(2) | Shares held directly by E15 Fund III, LP. The Reporting Person, as the managing partner of E15 Fund III, LP, may be deemed to share voting and dispositive power over the shares held by E15 Fund III, LP. The Reporting Person disclaims beneficial ownership of shares held by E15 Fund III, LP, 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. |
(4) | 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. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Liang Philip C/O VICARIOUS SURGICAL INC. 78 FOURTH AVENUE WALTHAM, MA 02451 | X |
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Signatures
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/s/ June Morris, Attorney-in-Fact | | 4/11/2023 |
**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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