0001104659-21-135808.txt : 20211108 0001104659-21-135808.hdr.sgml : 20211108 20211108185955 ACCESSION NUMBER: 0001104659-21-135808 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211104 FILED AS OF DATE: 20211108 DATE AS OF CHANGE: 20211108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chu Caroline CENTRAL INDEX KEY: 0001889114 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40973 FILM NUMBER: 211389356 MAIL ADDRESS: STREET 1: 400 ALTON ROAD STREET 2: UNIT TH-103M CITY: MIAMI BEACH STATE: FL ZIP: 33139 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Airsculpt Technologies, Inc. CENTRAL INDEX KEY: 0001870940 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-OFFICES & CLINICS OF DOCTORS OF MEDICINE [8011] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 ALTON ROAD, UNIT TH-103M CITY: MIAMI BEACH STATE: FL ZIP: 33139 BUSINESS PHONE: (786) 709-9690 MAIL ADDRESS: STREET 1: 400 ALTON ROAD, UNIT TH-103M CITY: MIAMI BEACH STATE: FL ZIP: 33139 4 1 tm2131199-12_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-11-04 0 0001870940 Airsculpt Technologies, Inc. AIRS 0001889114 Chu Caroline C/O AIRSCULPT TECHNOLOGIES, INC. 400 ALTON ROAD, UNIT TH-103M MIAMI BEACH FL 33139 1 0 0 0 Common Stock, $0.001 Par Value 2021-11-04 4 A 0 13910 0 A 13910 D Pursuant to Restricted Stock Units that will vest, subject to the individual's continued service with AirSculpt Technologies, Inc., on October 28, 2022. /s/ Thomas P. Conaghan, Attorney-in-Fact 2021-11-08