0001104659-21-141231.txt : 20211118
0001104659-21-141231.hdr.sgml : 20211118
20211118164657
ACCESSION NUMBER: 0001104659-21-141231
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211116
FILED AS OF DATE: 20211118
DATE AS OF CHANGE: 20211118
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bang Peter
CENTRAL INDEX KEY: 0001816380
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39841
FILM NUMBER: 211425015
MAIL ADDRESS:
STREET 1: 50 WASHINGTON STREET SUITE 921
CITY: NORWALK
STATE: CT
ZIP: 06844
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Kairos Acquisition Corp.
CENTRAL INDEX KEY: 0001824171
STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770]
IRS NUMBER: 000000000
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 50 WASHINGTON STREET
STREET 2: SUITE 921
CITY: NORWALK
STATE: CT
ZIP: 06854
BUSINESS PHONE: 9177834057
MAIL ADDRESS:
STREET 1: 50 WASHINGTON STREET
STREET 2: SUITE 921
CITY: NORWALK
STATE: CT
ZIP: 06854
4
1
tm2133417-4_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2021-11-16
0
0001824171
Kairos Acquisition Corp.
KAIR
0001816380
Bang Peter
C/O ELLENOFF GROSSMAN & SCHOLE LLP
1345 AVENUE OF THE AMERICAS, 11TH FLOOR
NEW YORK
NY
10105
1
1
0
0
Chief Executive Officer
Class B Ordinary Shares
2021-11-16
4
S
0
15000
0
D
Class A Ordinary Shares
15000
2940106
I
See Footnote
As described in the registrant's registration statement on Form S-1 (File No. 333-251553) under the heading "Description of Securities - Founder Shares", the Class B ordinary shares will automatically convert into Class A ordinary shares at the time of the registrant's initial business combination on a one-for-one basis (unless otherwise provided in the registrant's initial business combination agreement), subject to adjustment for share subdivisions, share consolidations, share capitalizations, reorganizations, recapitalizations and the like, and certain anti-dilution rights and have no expiration date.
These shares represent 2,940,106 Class B ordinary shares held by Kairos Alpha Acquisition LLC (the "Sponsor") which were subject to share dividends.
Mr. Bang is the sole managing member of the Sponsor and has voting and dispositive control over the shares held by the Sponsor and may be deemed the beneficial owner of such shares. Mr. Bang disclaims any beneficial ownership of the securities held by the Sponsor other than to the extent of any pecuniary interest he may have therein, directly or indirectly.
/s/ Peter Bang
2021-11-18