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