0001213900-24-005130.txt : 20240122 0001213900-24-005130.hdr.sgml : 20240122 20240122103705 ACCESSION NUMBER: 0001213900-24-005130 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240119 FILED AS OF DATE: 20240122 DATE AS OF CHANGE: 20240122 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WHITE MARK BRIAN CENTRAL INDEX KEY: 0001564335 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39783 FILM NUMBER: 24547412 MAIL ADDRESS: STREET 1: IMMEUBLE MILA CITY: CHAMPERY STATE: V8 ZIP: 1874 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FOXO TECHNOLOGIES INC. CENTRAL INDEX KEY: 0001812360 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMMERCIAL PHYSICAL & BIOLOGICAL RESEARCH [8731] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 851050265 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 729 WASHINGTON AVE. N STREET 2: SUITE 600 CITY: MINNEAPOLIS STATE: MN ZIP: 55401 BUSINESS PHONE: (612) 562-9447 MAIL ADDRESS: STREET 1: 729 WASHINGTON AVE. N STREET 2: SUITE 600 CITY: MINNEAPOLIS STATE: MN ZIP: 55401 FORMER COMPANY: FORMER CONFORMED NAME: Delwinds Insurance Acquisition Corp. DATE OF NAME CHANGE: 20200518 4 1 ownership.xml X0508 4 2024-01-19 0 0001812360 FOXO TECHNOLOGIES INC. FOXO 0001564335 WHITE MARK BRIAN 9 KING GEORGE V PLACE WIINCHESTER X0 SO22 SFU UNITED KINGDOM 1 1 1 0 Interim CEO 0 Class A Common Stock 2024-01-19 4 A 0 1300000 A 1300000 I See Note Class A Common Stock 250000 D Represents shares issued to KR8 ai Inc., of which the Reporting Person is an officer, director and shareholder as consideration for rights granted and services to be rendered pursuant to the Master Software and Services Agreement between KR8 ai Inc. and the issuer. /s/ Mark White 2024-01-22