0000950170-25-005998.txt : 20250115 0000950170-25-005998.hdr.sgml : 20250115 20250115210159 ACCESSION NUMBER: 0000950170-25-005998 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20250113 FILED AS OF DATE: 20250115 DATE AS OF CHANGE: 20250115 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Frank Edward H. CENTRAL INDEX KEY: 0001589827 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41139 FILM NUMBER: 25534127 MAIL ADDRESS: STREET 1: C/O FUSION-IO, INC. STREET 2: 2855 E. COTTONWOOD PARKWAY, SUITE 100 CITY: SALT LAKE CITY STATE: UT ZIP: 84121 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Blaize Holdings, Inc. CENTRAL INDEX KEY: 0001871638 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] ORGANIZATION NAME: 04 Manufacturing IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 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 FORMER COMPANY: FORMER CONFORMED NAME: BurTech Acquisition Corp. DATE OF NAME CHANGE: 20210708 4 1 ownership.xml 4 X0508 4 2025-01-13 0001871638 Blaize Holdings, Inc. BZAI 0001589827 Frank Edward H. C/O BLAIZE HOLDINGS, INC. 4659 GOLDEN FOOTHILL PARKWAY, SUITE 206 EL DORADO HILLS CA 95762 true false false false false Common Stock 2025-01-13 4 A false 90999 A 90999 D Stock Option 0.57 2025-01-13 4 A false 212169 A 2033-09-18 Common Stock 212169 212169 D Stock Option 1.18 2025-01-13 4 A false 350970 A 2034-10-23 Common Stock 350970 350970 D Stock Option 1.18 2025-01-13 4 A false 146237 A 2034-10-23 Common Stock 146237 146237 D Represents Earn-Out Shares, each of which represents a contingent right to receive one share of Common Stock if the trading price of the Issuer's Common Stock exceeds certain thresholds for 20 of 30 consecutive trading days post-closing of the Issuer's business combination. Represents securities received as part of the Issuer's business combination, in connection with that certain Agreement and Plan of Merger, dated as of December 22, 2023 and amended on April 22, 2024, October 24, 2024 and November 21, 2024 (the "Merger Agreement"), by and between the Issuer (formerly BurTech Acquisition Corp.), BurTech Merger Sub Inc., Blaize, Inc. ("Legacy Blaize") and for the limited purposes set forth therein, Burkhan Capital LLC, pursuant to which securities of Legacy Blaize were automatically converted into the right to receive stock options of the Issuer as set forth in the Merger Agreement. The stock option is fully vested and exercisable. The stock option vests as to one third of the underlying shares on December 1, 2025, and thereafter in 24 equal monthly installments /s/ Harminder Sehmi, Attorney-in-Fact 2025-01-15