0000899243-23-017901.txt : 20230809 0000899243-23-017901.hdr.sgml : 20230809 20230809175823 ACCESSION NUMBER: 0000899243-23-017901 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20230807 FILED AS OF DATE: 20230809 DATE AS OF CHANGE: 20230809 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KHOSLA VINOD CENTRAL INDEX KEY: 0001032453 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 231156515 MAIL ADDRESS: STREET 1: 2128 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: VK Services, LLC CENTRAL INDEX KEY: 0001501927 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 231156516 BUSINESS ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: (650) 376-8526 MAIL ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Khosla Ventures Associates V, LLC CENTRAL INDEX KEY: 0001611145 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 231156519 BUSINESS ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-376-8526 MAIL ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Khosla Ventures V, L.P. CENTRAL INDEX KEY: 0001611146 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 231156522 BUSINESS ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-376-8526 MAIL ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Khosla Ventures Opportunity II, L.P. CENTRAL INDEX KEY: 0001959115 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 231156521 BUSINESS ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-376-8500 MAIL ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Khosla Ventures Seed Associates C, LLC CENTRAL INDEX KEY: 0001627898 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 231156517 BUSINESS ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-376-8526 MAIL ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Khosla Ventures Seed C, L.P. CENTRAL INDEX KEY: 0001627897 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 231156518 BUSINESS ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-376-8526 MAIL ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Khosla Ventures Opportunity Associates II, LLC CENTRAL INDEX KEY: 0001959102 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 231156520 BUSINESS ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-376-8500 MAIL ADDRESS: STREET 1: 2128 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Vicarious Surgical Inc. CENTRAL INDEX KEY: 0001812173 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 78 FOURTH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: (617) 868-1700 MAIL ADDRESS: STREET 1: 78 FOURTH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 FORMER COMPANY: FORMER CONFORMED NAME: D8 Holdings Corp. DATE OF NAME CHANGE: 20200514 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-08-07 0 0001812173 Vicarious Surgical Inc. RBOT 0001611146 Khosla Ventures V, L.P. 2128 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001959115 Khosla Ventures Opportunity II, L.P. 2128 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001959102 Khosla Ventures Opportunity Associates II, LLC 2128 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001611145 Khosla Ventures Associates V, LLC 2128 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001627897 Khosla Ventures Seed C, L.P. 2128 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001627898 Khosla Ventures Seed Associates C, LLC 2128 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001501927 VK Services, LLC 2128 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001032453 KHOSLA VINOD 2128 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0 CLASS A COMMON STOCK 2023-08-07 4 P 0 8000000 1.00 A 8000000 I See footnote CLASS A COMMON STOCK 13059335 I See footnote CLASS A COMMON STOCK 7896787 I See footnote Consists of securities held of record by Khosla Ventures Opportunity II, L.P. ("KV Opportunity II"), of which Khosla Ventures Opportunity Associates II, LLC ("KV Opportunity Associates") is the general partner. Vinod Khosla is the managing member of VK Services, LLC ("VK Services") which is the sole manager of KV Opportunity Associates. Each of KV Opportunity Associates V, VK Services, and Vinod Khosla may be deemed to have indirect beneficial ownership of such securities held by KV Opportunity II. Each Reporting Person disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interests therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. Consists of securities held of record by Khosla Ventures V, L.P. ("KV V"), of which Khosla Ventures Associates V, LLC ("KVA V") is the general partner. Vinod Khosla is the managing member of VK Services, which is the sole manager of KVA V. Each of KVA V, VK Services and Vinod Khosla may be deemed to possess voting and investment control over such securities held by KV V, and each of KVA V, VK Services, and Vinod Khosla may be deemed to have indirect beneficial ownership of such securities held by KV V. Each Reporting Person disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interests therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. Consists of securities held of record by Khosla Ventures Seed C, L.P. ("KV Seed C"), of which Khosla Ventures Seed Associates C, LLC ("KVA Seed C") is the general partner. Vinod Khosla is the managing member of VK Services, LLC ("VK Services"), which is the sole manager of KVA Seed C. Each of KVA Seed C, VK Services and Vinod Khosla may be deemed to possess voting and investment control over such securities held by KV Seed C, and each of KVA Seed C, VK Services and Vinod Khosla may be deemed to have indirect beneficial ownership of such securities held by KV Seed C. Each Reporting Person disclaims beneficial ownership of such shares except to the extent of his or its respective pecuniary interests therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. Exhibit Index: 24.1 Power of Attorney /s/ John J. Demeter, as attorney in fact for Vinod Khosla, as Managing Member of VK Services, LLC, in its capacity as Manager of Khosla Ventures Opportunity Associates II, LLC, in its capacity as general partner of Khosla Ventures Opportunity II, L.P. 2023-08-09 /s/ John J. Demeter, as attorney in fact for Vinod Khosla, as Managing Member of VK Services, LLC, in its capacity as Manager of Khosla Ventures Opportunity Associates II, LLC 2023-08-09 /s/ John J. Demeter, as attorney in fact for Vinod Khosla, as Managing Member of VK Services, LLC, in its capacity as Manager of Khosla Ventures Associates V, LLC, in its capacity as general partner of Khosla Ventures V, L.P. 2023-08-09 /s/ John J. Demeter, as attorney in fact for Vinod Khosla, as Managing Member of VK Services, LLC, in its capacity as Manager of Khosla Ventures Associates V, LLC 2023-08-09 /s/ John J. Demeter, as attorney in fact for Vinod Khosla, as Managing Member of VK Services, LLC, in its capacity as Manager of Khosla Ventures Seed Associates C, LLC, in its capacity as general partner of Khosla Ventures Seed C, L.P. 2023-08-09 /s/ John J. Demeter, as attorney in fact for Vinod Khosla, as Managing Member of VK Services, LLC, in its capacity as Manager of Khosla Ventures Seed Associates C, LLC 2023-08-09 /s/ John J. Demeter, as attorney in fact for Vinod Khosla, as Managing Member of VK Services, LLC 2023-08-09 /s/ John J. Demeter, as attorney in fact for Vinod Khosla 2023-08-09 EX-24.1 2 attachment1.htm EX-24.1 DOCUMENT

                                                                    Exhibit 24.1

            LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS

      Know all by these present that the undersigned hereby makes, constitutes
and appoints each of Samir Kaul, John Demeter and Kimberly Totah, signing singly
and each acting individually, as the undersigned's true and lawful
attorney-in-fact with full power and authority as hereinafter described to:

(1)     prepare, execute in the undersigned's name and on the undersigned's
behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a
Form ID, including amendments thereto, an Update Passphrase and any other
application materials necessary or appropriate to obtain codes and passwords
enabling the undersigned to gain or maintain access to the Electronic Data
Gathering, Analysis and Retrieval system of the SEC and make electronic filings
with the SEC of reports required by Section 16(a) of the Securities Exchange Act
of 1934 (the "Exchange Act") or any rule or regulation of the SEC;

(2)     execute for and on behalf of the undersigned, in his own capacity and in
the undersigned's capacity as managing manager of VK Services, LLC, Forms 3, 4,
and 5 (including any amendments thereto) in accordance with Section 16(a) of the
Exchange Act;

(3)     do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to prepare, complete and execute any such
Form 3, 4, or 5, or other form or report, prepare, complete and execute any
amendment or amendments thereto, and timely deliver and file such form or report
with the SEC and any stock exchange or similar authority;

(4)     seek or obtain, as the undersigned's representative and on the
undersigned's behalf, information regarding transactions in any of the
securities issued by entities in which any of Khosla Ventures I, L.P., Khosla
Ventures II, L.P., Khosla Ventures III, L.P., Khosla Ventures IV, L.P., Khosla
Ventures IV (CF), L.P., Khosla Ventures V, L.P., Khosla Ventures VI, L.P.,
Khosla Ventures VII, L.P., Khosla Ventures VIII, L.P., Khosla Ventures Seed,
L.P., Khosla Ventures Seed Side Fund, L.P., Khosla Ventures Seed B, L.P., Khosla
Ventures Seed B (CF), L.P., Khosla Ventures Seed C, L.P., Khosla Ventures
Seed D, L.P., Khosla Ventures Seed E, L.P., Khosla Ventures Seed F, L.P., Khosla
Ventures Opportunity, L.P., Khosla Ventures Opportunity II, L.P. and Khosla
Ventures Excelsior, L.P. has made an investment (each and any of such entities,
the "Khosla Portfolio Companies") from any third party, including brokers,
employee benefit plan administrators and trustees, and the undersigned hereby
authorizes any such person to release any such information to such
attorney-in-fact and approves and ratifies any such release of information; and

(5)     take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.

      The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this power of attorney and the rights and powers herein
granted.  The undersigned acknowledges that the
foregoing attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming or relieving, nor is VK Services, LLC assuming or
relieving, any of the undersigned's responsibilities to comply with Section 16
of the Exchange Act.  The undersigned acknowledges that neither VK Services, LLC
nor the foregoing attorneys-in-fact assumes (i) any liability for the
undersigned's responsibility to comply with the requirements of the Exchange
Act, (ii) any liability of the undersigned for any failure to comply with such
requirements, or (iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act.

      This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, or 5 with respect to the
undersigned's holdings of and transactions in securities issued by any of the
Khosla Portfolio Companies, unless earlier revoked by the undersigned in a
signed writing delivered to the foregoing attorneys-in-fact.

      IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be executed as of this 9th day of August, 2023.


                                                    /s/ Vinod Khosla
                                                    ---------------------------
                                                    Signature

                                                    Vinod Khosla
                                                    ----------------------------
                                                    Print Name