0001104659-21-001199.txt : 20210105 0001104659-21-001199.hdr.sgml : 20210105 20210105215620 ACCESSION NUMBER: 0001104659-21-001199 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210105 FILED AS OF DATE: 20210105 DATE AS OF CHANGE: 20210105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Koehn Garrett CENTRAL INDEX KEY: 0001816388 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39841 FILM NUMBER: 21508888 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 3 1 tm211735d4_3seq1.xml OWNERSHIP DOCUMENT X0206 3 2021-01-05 1 0001824171 Kairos Acquisition Corp. KAIRU 0001816388 Koehn Garrett C/O ELLENOFF GROSSMAN & SCHOLE LLP 1345 AVENUE OF THE AMERICAS, 11TH FLOOR NEW YORK NY 10105 1 0 0 0 The reporting person has an indirect pecuniary interest in shares of Class B ordinary shares of the registrant through his membership interest in Kairos Alpha Acquisition LLC (the "Sponsor"), over which the reporting person does not have voting or dispositive control. /s/ Garrett Koehn 2021-01-05