Statement of Changes in Beneficial Ownership (4)
16 July 2022 - 6:34AM
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
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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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CHU DAVID |
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)
_____ 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 |
(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
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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, par value $0.0001 per share | 7/13/2022 | | J(1)(3) | | 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) | | 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
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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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