0001104659-21-141306.txt : 20211118 0001104659-21-141306.hdr.sgml : 20211118 20211118173059 ACCESSION NUMBER: 0001104659-21-141306 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: Millette Michael CENTRAL INDEX KEY: 0001835582 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39841 FILM NUMBER: 211425640 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 4 1 tm2133417-3_4.xml FORM 4 X0306 4 2021-11-16 0 0001824171 Kairos Acquisition Corp. KAIR 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 2021-11-16 4 P 0 15000 0 A Class A Ordinary Shares 15000 3959894 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. Vikas Singhal, a Director of the issuer, and Michael Millette, the board observer of the issuer, are the Partners 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 Messrs. Singhal and Millette also serve as officers. Therefore, Messrs. Singhal and Millette manage, 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 owners of all the ordinary shares beneficially owned by the HSCM Holders. Messrs. Singhal and 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 2021-11-18