0001104659-21-002167.txt : 20210107 0001104659-21-002167.hdr.sgml : 20210107 20210107212334 ACCESSION NUMBER: 0001104659-21-002167 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210105 FILED AS OF DATE: 20210107 DATE AS OF CHANGE: 20210107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Millette Michael CENTRAL INDEX KEY: 0001835582 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39841 FILM NUMBER: 21515418 MAIL ADDRESS: STREET 1: 2187 ATLANTIC STREET STREET 2: FOURTH FLOOR CITY: STAMFORD STATE: CT ZIP: 06902 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 3 1 tm211843-2_3.xml OWNERSHIP DOCUMENT X0206 3 2021-01-05 0 0001824171 Kairos Acquisition Corp. KAIRU 0001835582 Millette Michael C/O HUDSON STRUCTURED CAPITAL MGMT LTD. 2187 ATLANTIC STREET - 4TH FLOOR STAMFORD CT 06902 0 0 1 1 Board Observer Class B Ordinary Shares Class A Ordinary Shares 3944894 I See footenote 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 our 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. Mr. Millette is the Managing Partner of Hudson Structured Capital Management Ltd. ("HSCM") which manages HSCM Bermuda Fund Ltd. ("HSCM Fund One") and HS Santanoni LP ("HSCM Fund Two"). HSCM Fund One and HSCM Fund Two jointly own HS Chronos LLC, of which Mr. Millette also serves as an officer. Therefore, Mr. Millette manages, directly or indirectly, each of HS Chronos LLC, HSCM Fund One, HSCM Fund Two and HSCM (collectively, the "HSCM Holders"), and therefore may be deemed to be the beneficial owner of all the ordinary shares beneficially owned by the HSCM Holders. Mr. Millette, HSCM Fund One, HSCM Fund Two and HSCM disclaim beneficial ownership of the ordinary shares except to the extent of their respective pecuniary interests therein. /s/ Michael Millette 2021-01-07