Patrick Francis Orlando - 10 Dec 2021 Form 3 Insider Report for BurTech Acquisition Corp. (BZAI)

Reporting relationship: 10%+ Owner
Issuer ticker: BZAI
Reported as of: 10 Dec 2021
Net transaction value: $0
SEC form: 3
Accepted by SEC: 13 Dec 2021, 15:22:37 UTC
Prior SEC filing: 10 Sep 2021
Next SEC filing: 11 Mar 2022
Source filing: View source filing
Reporting owner signature: /s/ Patrick Orlando

Key filing fact

Patrick Francis Orlando filed Form 3 for BurTech Acquisition Corp. (BZAI) on 13 Dec 2021.

Key facts

This page summarizes Patrick Francis Orlando's Form 3 filing for BurTech Acquisition Corp. (BZAI).
0 reported transactions and 1 derivative row are listed below.
Accepted by SEC: 13 Dec 2021, 15:22.

Change

Previous filing in this sequence was filed on 10 Sep 2021.
Current net transaction value: $0.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Official SEC source

Ownership activity is grounded in SEC Form 3 disclosures.

View source filing

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

BRKH holding

Class A Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 804,500
Date: 10 Dec 2021
Ownership: See Footnote
Footnotes: F1, F3

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

BRKH holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 10 Dec 2021
Ownership: See Footnote
Underlying class: Class A Common Stock
Underlying amount: 9,487,500
Exercise price
Footnotes: F2, F3

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 3 footnotes

Footnote F1

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".

Footnote F2

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.

Footnote F3

As a manager of the Sponsor, the reporting person may be deemed to have beneficial ownership of the securities held directly by the Sponsor, and disclaims any beneficial ownership of the reported shares other than to the extent of any pecuniary interest he may have therein, directly or indirectly.