0001849089-23-000055.txt : 20231215 0001849089-23-000055.hdr.sgml : 20231215 20231215141453 ACCESSION NUMBER: 0001849089-23-000055 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231213 FILED AS OF DATE: 20231215 DATE AS OF CHANGE: 20231215 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: 231489767 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 wk-form4_1702667683.xml FORM 4 X0508 4 2023-12-13 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 0 Common Stock 2023-12-13 4 P 0 6085.19 14.79 A 58460.45 D On December 13, 2023, 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 $90,000, and on December 13, 2023, the Company issued 6,085.19 shares of Common Stock to Damien Dwin. s/ Damien Dwin 2022-12-15