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