Shahal Khan - Dec 10, 2021 Form 3 Insider Report for BurTech Acquisition Corp. (BRKH)

Role
Chief Executive Officer, Director, 10%+ Owner
Signature
/s/ Shahal Khan
Stock symbol
BRKH
Transactions as of
Dec 10, 2021
Transactions value $
$0
Form type
3
Date filed
12/13/2021, 03:22 PM
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding BRKH Class A Common Stock 805K Dec 10, 2021 See Footnote F1, F3

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
holding BRKH Class B Common Stock Dec 10, 2021 Class A Common Stock 9.49M See Footnote F2, F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
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".
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.
F3 As the 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.