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