0001213900-22-005113.txt : 20220202 0001213900-22-005113.hdr.sgml : 20220202 20220202191006 ACCESSION NUMBER: 0001213900-22-005113 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220131 FILED AS OF DATE: 20220202 DATE AS OF CHANGE: 20220202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chelvey International Ltd CENTRAL INDEX KEY: 0001884829 STATE OF INCORPORATION: D8 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 22585514 BUSINESS ADDRESS: STREET 1: C/O VICARIOUS SURGICAL INC. STREET 2: 78 4TH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: 617-868-1700 MAIL ADDRESS: STREET 1: C/O VICARIOUS SURGICAL INC. STREET 2: 78 4TH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Liang Philip CENTRAL INDEX KEY: 0001883781 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 22585512 MAIL ADDRESS: STREET 1: C/O VICARIOUS SURGICAL INC. STREET 2: 78 4TH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: E15 Fund II, LP CENTRAL INDEX KEY: 0001885992 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 22585513 BUSINESS ADDRESS: STREET 1: C/O VICARIOUS SURGICAL INC. STREET 2: 78 4TH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: 617-868-1700 MAIL ADDRESS: STREET 1: C/O VICARIOUS SURGICAL INC. STREET 2: 78 4TH AVENUE CITY: WALTHAM STATE: MA ZIP: 02451 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Patnaik Shrikant CENTRAL INDEX KEY: 0001885980 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 22585511 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 OWNERSHIP DOCUMENT X0306 4 2022-01-31 0 0001812173 Vicarious Surgical Inc. RBOT 0001884829 Chelvey International Ltd C/O VICARIOUS SURGICAL INC. 78 FOURTH AVENUE WALTHAM MA 02451 0 0 1 0 0001885992 E15 Fund II, LP C/O VICARIOUS SURGICAL INC. 78 FOURTH AVENUE WALTHAM MA 02451 0 0 1 0 0001883781 Liang Philip C/O VICARIOUS SURGICAL INC. 78 FOURTH AVENUE WALTHAM MA 02451 1 0 1 0 0001885980 Patnaik Shrikant C/O VICARIOUS SURGICAL INC. 78 FOURTH AVENUE WALTHAM MA 02451 0 0 1 0 Class A Common Stock 2022-01-31 4 J 0 398985 0 D 9637865 D Chelvey International Limited distributed these shares to its sole shareholder, E15 Fund II, LP, on a pro rata basis, for no consideration. In connection with such distribution, E15 Fund II, LP subsequently distributed these shares to its limited partners on a pro rata basis, for no consideration. 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. Philip Liang is the managing partner of E15 Fund II, LP and Shrikant Patnaik is a principal of E15 Fund II, LP and may be deemed to share voting and dispositive power over the shares held by Chelvey International Limited. Such persons and entities disclaim beneficial ownership of shares held by Chelvey International Limited, except to the extent of any pecuniary interest therein. /s/ June Morris, Attorney-in-Fact 2022-02-02