0001104659-21-148785.txt : 20211210
0001104659-21-148785.hdr.sgml : 20211210
20211210215815
ACCESSION NUMBER: 0001104659-21-148785
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211210
FILED AS OF DATE: 20211210
DATE AS OF CHANGE: 20211210
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Burtech LP LLC
CENTRAL INDEX KEY: 0001878670
STATE OF INCORPORATION: DE
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41139
FILM NUMBER: 211486825
BUSINESS ADDRESS:
STREET 1: 1300 PENNSYLVANIA AVE NW, SUITE 700
CITY: WASHINGTON
STATE: DC
ZIP: 20004
BUSINESS PHONE: 6504408969
MAIL ADDRESS:
STREET 1: 1300 PENNSYLVANIA AVE NW, SUITE 700
CITY: WASHINGTON
STATE: DC
ZIP: 20004
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: BurTech Acquisition Corp.
CENTRAL INDEX KEY: 0001871638
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 7770 NORFOLK AVE
CITY: BETHESDA
STATE: MD
ZIP: 20814
BUSINESS PHONE: 2027908050
MAIL ADDRESS:
STREET 1: 7770 NORFOLK AVE
CITY: BETHESDA
STATE: MD
ZIP: 20814
3
1
tm2135211-10_3.xml
OWNERSHIP DOCUMENT
X0206
3
2021-12-10
0
0001871638
BurTech Acquisition Corp.
BRKHU
0001878670
Burtech LP LLC
C/O BURTECH ACQUISITION CORP.,
1300 PENNSYLVANIA AVENUE, NW, SUITE 700
WASHINGTON
DC
20004
0
0
1
0
Class A Common Stock
804500
D
Class B Common Stock
Class A Common Stock
9487500
D
These shares represent 804,500 shares of Class A common stock of the issuer held by the Reporting Person included in the Placement Units as described in the issuer's registration statement on Form S-1 (File No. 333-258914) under the heading "Description of Securities".
As described in the issuer's registration statement on Form S-1 (File No. 333-258914) under the heading "Description of Securities", the shares of Class B common stock will automatically convert into shares of Class A common stock at the time of the registrant's initial business combination on a one-for-one basis, subject to certain adjustments described therein and have no expiration date.
These shares represent 9,487,500 shares of Class B common stock of the issuer held by the Reporting Person, including an aggregate of up to 1,237,500 shares subject to forfeiture by the Reporting Person to the extent that the underwriter's over-allotment is not exercised in full or in part.
By: /s/ Shahal Khan, Authorized person of BurTech LP LLC
2021-12-10