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