0001104659-21-148786.txt : 20211210
0001104659-21-148786.hdr.sgml : 20211210
20211210215848
ACCESSION NUMBER: 0001104659-21-148786
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: Golden Leon
CENTRAL INDEX KEY: 0001897868
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41139
FILM NUMBER: 211486826
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
tm2135211-5_3.xml
OWNERSHIP DOCUMENT
X0206
3
2021-12-10
0
0001871638
BurTech Acquisition Corp.
BRKHU
0001897868
Golden Leon
C/O BURTECH ACQUISITION CORP.,
1300 PENNSYLVANIA AVENUE, NW, SUITE 700
WASHINGTON
DC
20004
1
0
0
0
Class A Common Stock
0
I
See Footnote
Class B Common Stock
Class A Common Stock
0
I
See Footnote
These shares represent 804,500 shares of Class A common stock of the issuer held by the Sponsor 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".
These shares represent the common stock held by BurTech LP, LLC (the "Sponsor"), acquired pursuant to a private placement by and between the Sponsor and the registrant. The common stock owned by the Sponsor includes up to 1,237,500 shares that are subject to forfeiture in the event the underwriters of the initial public offering of the registrant's securities do not exercise in full their over-allotment option as described in the registrant's registration statement.
The reporting person is, directly or indirectly, a member of our sponsor or has direct or indirect economic interests in our sponsor, and may be deemed to have beneficial ownership of the securities held directly by the Sponsor, and disclaims any beneficial ownership of the reported securities other than to the extent of any pecuniary interest he may have therein, directly or indirectly.
/s/ Leon Golden
2021-12-10