0001213900-22-033363.txt : 20220616 0001213900-22-033363.hdr.sgml : 20220616 20220616165835 ACCESSION NUMBER: 0001213900-22-033363 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220615 FILED AS OF DATE: 20220616 DATE AS OF CHANGE: 20220616 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Khalifa Sammy CENTRAL INDEX KEY: 0001883777 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39384 FILM NUMBER: 221021295 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 2022-06-15 0 0001812173 Vicarious Surgical Inc. RBOT 0001883777 Khalifa Sammy C/O VICARIOUS SURGICAL INC. 78 4TH AVENUE WALTHAM MA 02451 1 1 1 0 Chief Technology Officer Class A Common Stock 2022-06-15 4 C 0 4551 A 1053959 D Class A Common Stock 2022-06-15 4 S 0 4551 3.2217 D 1049408 D Class B Common Stock 2022-06-15 4 C 0 4551 0 D Class A Common Stock 4551 4538015 D Each share of Class B Common Stock, par value $0.0001 per share (the "Class B Common Stock"), was converted into one share of Class A Common Stock, par value $0.0001 per share (the "Class A Common Stock"), for no additional consideration at the option of the Reporting Person. The shares of Class B Common Stock are convertible into an equal number of shares of Class A Common Stock at the Reporting Person's election and have no expiration date. These shares were sold pursuant to a Rule 10b5-1 trading plan entered into by the Reporting Person. This figure is the weighted average sales price of multiple trades ranging from $3.180 to $3.245 per share. The Reporting Person undertakes to provide the staff of the Securities Exchange Commission, Vicarious Surgical Inc. or any security holder of Vicarious Surgical Inc. full information about the number of shares sold at each separate price upon request. /s/ June Morris, Attorney-in-Fact 2022-06-16