0001213900-21-049655.txt : 20210923
0001213900-21-049655.hdr.sgml : 20210923
20210923212907
ACCESSION NUMBER: 0001213900-21-049655
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210917
FILED AS OF DATE: 20210923
DATE AS OF CHANGE: 20210923
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Innovation Endeavors III LP
CENTRAL INDEX KEY: 0001720215
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39384
FILM NUMBER: 211273878
BUSINESS ADDRESS:
STREET 1: 10 EAST 53RD STREET, 14TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 212-937-9095
MAIL ADDRESS:
STREET 1: 10 EAST 53RD STREET, 14TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Berman Dror
CENTRAL INDEX KEY: 0001883780
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39384
FILM NUMBER: 211273877
MAIL ADDRESS:
STREET 1: C/O VICARIOUS SURGICAL INC.
STREET 2: 78 4TH AVENUE
CITY: WALTHAM
STATE: MA
ZIP: 02451
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
ownership.xml
X0306
4
2021-09-17
0
0001812173
Vicarious Surgical Inc.
RBOT
0001720215
Innovation Endeavors III LP
C/O VICARIOUS SURGICAL INC.
78 FOURTH AVENUE
WALTHAM
MA
02451
0
0
1
0
0001883780
Berman Dror
C/O VICARIOUS SURGICAL INC.
78 FOURTH AVENUE
WALTHAM
MA
02451
1
0
0
0
Class A Common Stock
2021-09-17
4
A
0
13436810
A
13436810
D
In connection with the closing of the transactions contemplated by the Agreement and Plan of Merger, dated as of April 15, 2021, by and among D8 Holdings Corp. ("D8"), Snowball Merger Sub, Inc., a Delaware corporation and wholly owned subsidiary of D8 ("Merger Sub"), and Vicarious Surgical Inc., a Delaware corporation ("Vicarious"), pursuant to which Merger Sub merged with and into Vicarious, with Vicarious surviving as a wholly-owned subsidiary of D8 (which changed its name to "Vicarious Surgical Inc.", the "Issuer"), these shares were received in exchange for 3,313,025 Series A1 Preferred Stock, 456,520 Series A2 Preferred Stock and 304,302 Series A3 Preferred Stock of Vicarious.
Dror Berman is a managing partner at Innovation Endeavors III LP and may be deemed to share voting and dispositive power over the shares held by Innovation Endeavors III LP. Such persons and entities disclaim beneficial ownership of shares held by Innovation Endeavors III LP, except to the extent of any pecuniary interest therein.
/s/ June Morris, Attorney-in-Fact
2021-09-21