Statement of Ownership (sc 13g)
February 14 2022 - 5:18PM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
LAVA Medtech Acquisition Corp.
(Name of Issuer)
Class A common stock, par value $0.0001 per
share
(Title of Class of Securities)
519345201
(CUSIP Number)
December 31, 2021
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this
Schedule is filed:
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*
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The remainder of this cover page shall be filled out for a reporting person’s initial filing on
this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures
provided in a prior cover page.
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The information required on the remainder of this
cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”)
or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see
the Notes).
1
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NAME OF REPORTING PERSONS
LAVA Medtech Sponsor LP
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2
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Check the Appropriate Box if a Member of a Group
(See Instructions)
(a) ☐ (b)
☐
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3
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SEC USE ONLY
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4
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CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON WITH
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5
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SOLE VOTING POWER
0
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6
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SHARED VOTING POWER
2,875,000(1)
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7
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SOLE DISPOSITIVE POWER
0
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8
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SHARED DISPOSITIVE POWER
2,875,000(1)(2)
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9
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING
PERSON
2,875,000(1)(2)
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10
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES
☐
See footnote (2) below.
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11
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW
(9)
20% (1)(2)(3)
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12
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TYPE OF REPORTING PERSON (See Instructions)
PN
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1
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NAME OF REPORTING PERSONS
LAVA Medtech Manager LLC
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2
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Check the Appropriate Box if a Member of a Group
(See Instructions)
(a) ☐ (b)
☐
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3
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SEC USE ONLY
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4
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CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware
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NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON WITH
|
5
|
SOLE VOTING POWER
0
|
6
|
SHARED VOTING POWER
2,875,000(1)
|
7
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SOLE DISPOSITIVE POWER
0
|
8
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SHARED DISPOSITIVE POWER
2,875,000(1)(2)
|
9
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING
PERSON
2,875,000(1)(2)
|
10
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES
☐
See footnote (2) below.
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11
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW
(9)
20% (1)(2)(3)
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12
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TYPE OF REPORTING PERSON (See Instructions)
OO
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(1)
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See Item 4. These are the Issuer’s shares of Class B common stock, which will automatically convert into the
Issuer’s shares of Class A common stock at the time of the Issuer’s initial business combination and as more fully
described under the heading “Description of Securities-Founder Shares” in the Issuer’s registration statements on
Form S-1/A (File No. 333- 259983). LAVA Medtech Manager LLC is the General Partner of LAVA Medtech Sponsor LP. Consequently, LAVA
Medtech Manager LLC may be deemed the beneficial owner of the shares held by LAVA Acquisition Sponsor LP, as applicable, and share
voting and dispositive control over such securities.
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(2)
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Excludes 8,175,000 shares which may be purchased by exercising warrants that are not presently exercisable.
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(3)
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Based on 14,375,000 shares of Class A and Class B common stock issued and outstanding as of December 10, 2021 as reported in the Issuer’s
Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on December 10, 2021.
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Item 1(a).
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Name of Issuer
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LAVA Medtech Acquisition Corp.
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Item 1(b).
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Address of the Issuer’s Principal Executive Offices
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303 Wyman Street, Suite 300
Waltham, MA 02451
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Item 2(a).
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Names of Persons Filing
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LAVA Medtech Sponsor LP
LAVA Medtech Manager LLC
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Item 2(b).
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Address of the Principal Business Office, or if none, Residence:
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303 Wyman Street, Suite 300
Waltham, MA 02451
LAVA Medtech Sponsor LP is a Delaware limited partnership.
LAVA Medtech Manager LLC is a Delaware limited liability
company.
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Item 2(d).
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Title of Class of Securities
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Class A common stock, $0.0001 par value per share.
519345201
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Item 3.
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If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a:
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☐
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(a) Broker or Dealer registered under Section 15 of the Exchange Act.
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☐
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(b) Bank as defined in Section 3(a)(b) or the Exchange Act.
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☐
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(c) Insurance company as defined in Section 3(a)(19) of the Exchange Act.
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☐
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(d) Investment company registered under Section 8 of the Investment Company Act.
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☐
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(e) An Investment adviser in accordance with Rule 13d-1 (b)(1)(ii)(e).
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☐
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(f) An employee benefit plan or endowment fund in accordance with Rule 13d 1(b)(1)(ii)(f).
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☐
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(g) A Parent Holding Company or control person in accordance with Rule 13d 1(b)(1)(ii)(g).
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☐
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(h) A Savings Association as defined in Section 3(b) of the Federal Deposit Insurance Act.
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☐
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(i) A Church Plan that is excluded from the definition of an investment company under Section 3 (c)(14) of the Investment Company
Act.
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☐
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(j) Group, in accordance with Rule 13d-1 (b)(1)(ii)(j).
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Not applicable
The responses to Items 5-11 of the cover pages of this Schedule
13G are incorporated herein by reference.
As of December 31, 2021, the Reporting Persons may be deemed
to beneficially own 2,875,000 of the Issuer’s Class B common stock, representing 20% of the total shares of common stock issued
and outstanding. The terms of these Class B common stock are more fully described under the heading “Description of Securities-Founder
Shares” in the Issuer’s registration statements on Form S-1/A (File No. 333- 259983).
The percentage of the common stock held by the Reporting Persons
is based on 14,375,000 shares of Class A and Class B common stock issued and outstanding as of December 10, 2021 as reported in the Issuer’s
Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on December 10, 2021.
LAVA Medtech Sponsor LP is the record holder of the shares
reported herein. LAVA Medtech Manager LLC is the General Partner of LAVA Medtech Sponsor LP. Consequently, LAVA Medtech Manager LLC may be deemed
the beneficial owner of the shares held by LAVA Medtech Sponsor LP, as applicable, and share voting and dispositive control over such
securities.
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Item 5.
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Ownership of Five Percent or Less of a Class
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Not Applicable
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Item 6.
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Ownership of More than Five Percent on Behalf of Another
Person
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Not Applicable
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Item 7.
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Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company
or Control Person
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Not Applicable
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Item 8.
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Identification and Classification of Members of the
Group
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Not Applicable
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Item 9.
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Notice of Dissolution of Group
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Not Applicable
Not Applicable
SIGNATURE
After reasonable inquiry and to the best of my
knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
DATE: February 14, 2022
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LAVA MEDTECH SPONSOR LP
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By: LAVA Medtech Manager LLC, General Partner
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By:
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/s/ Anthony Natale
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Name:
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Anthony Natale
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Title:
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Member
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By:
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/s/ Gerry Brunk
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Name:
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Gerry Brunk
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Title:
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Member
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By:
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/s/ Peter van der Velden
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Name:
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Peter van der Velden
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Title:
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Member
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LAVA MEDTECH MANAGER LLC
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By:
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/s/ Anthony Natale
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Name:
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Anthony Natale
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Title:
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Member
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By:
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/s/ Gerry Brunk
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Name:
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Gerry Brunk
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Title:
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Member
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By:
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/s/ Peter van der Velden
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Name:
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Peter van der Velden
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Title:
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Member
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Attention: Intentional misstatements or omissions
of fact constitute Federal criminal violations
(See 18 U.S.C. 1001)
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