0001213900-22-011641.txt : 20220310 0001213900-22-011641.hdr.sgml : 20220310 20220310173021 ACCESSION NUMBER: 0001213900-22-011641 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220106 FILED AS OF DATE: 20220310 DATE AS OF CHANGE: 20220310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Briones David S. CENTRAL INDEX KEY: 0001599831 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41184 FILM NUMBER: 22730236 MAIL ADDRESS: STREET 1: C/O PETRO RIVER OIL COMPANY STREET 2: 1980 POST OAK BLVD., SUITE 2020 CITY: HOUSTON STATE: TX ZIP: 77056 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Larkspur Health Acquisition Corp. CENTRAL INDEX KEY: 0001859007 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 862685744 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 217 W. MAIN STREET CITY: SOMERVILLE STATE: NJ ZIP: 08876 BUSINESS PHONE: 908-370-5102 MAIL ADDRESS: STREET 1: 217 W. MAIN STREET CITY: SOMERVILLE STATE: NJ ZIP: 08876 4 1 ownership.xml X0306 4 2022-01-06 0 0001859007 Larkspur Health Acquisition Corp. LSPR 0001599831 Briones David S. 100 SOMERSET CORPORATE BLVD., 2ND FLOOR BRIDGEWATER NJ 08807 1 1 0 0 Chief Financial Officer Class A Common Stock 2022-01-06 4 J 0 10752 0.00 A 10752 I see footnote Class B common stock 2022-01-06 4 J 0 1533 0.00 D Class A common stock 1533 55967 I see footnote Class B common stock 2022-01-06 4 J 0 91 0.00 A Class A common stock 156 56123 I see footnote These shares are underlying units (each unit consisting of one share of Class A common stock and three-fourths of one warrant, each whole warrant exercisable to purchase one share of Class A common stock) acquired in a private placement by the Larkspur Health LLC (the "Sponsor") in connection with the issuer's initial public offering and subsequent partial exercise of the underwriters' over-allotment option. The above refers to the shares of Class A common stock included in the units purchased. The shares represent those owned by Mr. Briones, a member of Larkspur Health LLC based on his pro rata share of ownership of Larkspur Health LLC. As described in the Issuer's registration statement on Form S-1 (File No. 333-256056) (the "Registration Statement") under the section entitled "Description of Securities - Founder Shares," the shares of Class B Common Stock, par value $0.0001 per share, will automatically be converted into shares of Class A Common Stock, par value $0.0001 per share, at the time of the Issuer's initial business combination, on a one-for-one basis, subject to certain adjustment described therein, and have no expiration date As contemplated in connection with the initial public offering of the Issuer, 22,343 shares of Class B common stock of the Issuer were forfeited for no consideration and cancelled because the underwriters of the Issuer's initial public offering did not exercise their over-allotment option in full, as described in the Issuer's Registration Statement. In connection with the partial exercise of the underwriters' over-allotment option, A.G.P./Alliance Global Partners transferred 3,427 shares to the Sponsor for no consideration. /s/ David Briones 2022-03-10