0001849089-22-000036.txt : 20220914 0001849089-22-000036.hdr.sgml : 20220914 20220914195650 ACCESSION NUMBER: 0001849089-22-000036 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220913 FILED AS OF DATE: 20220914 DATE AS OF CHANGE: 20220914 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dwin Damien CENTRAL INDEX KEY: 0001875321 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 814-01427 FILM NUMBER: 221244216 MAIL ADDRESS: STREET 1: PO BOX 25250, PMB 13941 CITY: MIAMI STATE: FL ZIP: 33102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lafayette Square USA, Inc. CENTRAL INDEX KEY: 0001849089 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 175 SW 7TH STREET STREET 2: UNIT 1911 CITY: MIAMI STATE: FL ZIP: 33130 BUSINESS PHONE: 7866880975 MAIL ADDRESS: STREET 1: 175 SW 7TH STREET STREET 2: UNIT 1911 CITY: MIAMI STATE: FL ZIP: 33130 FORMER COMPANY: FORMER CONFORMED NAME: Lafayette Square Empire BDC, Inc. DATE OF NAME CHANGE: 20211101 FORMER COMPANY: FORMER CONFORMED NAME: Lafayette Square Empire BDC, LLC DATE OF NAME CHANGE: 20210303 4 1 wf-form4_166319979612323.xml FORM 4 X0306 4 2022-09-13 0 0001849089 Lafayette Square USA, Inc. NONE 0001875321 Dwin Damien C/O LAFAYETTE SQUARE USA, INC. PO BOX 25250, PMB 13941 MIAMI FL 33102 1 1 0 0 President and CEO Common Stock 2022-09-13 4 P 0 17076.50 14.64 A 33743.17 D On August 29, 2022 Lafayette Square USA, Inc. (the "Company") issued a capital call notice to certain investors that have committed to purchase shares of Common Stock. Pursuant to such capital call notice, Damien Dwin was obligated to make a capital contribution of $249,999.96, and on September 13, 2022, the Company issued 17,076.50 shares of Common Stock to Damien Dwin. s/ Damien Dwin 2022-09-14