UAW Retiree Medical Benefits Trust

07/26/2024 | Press release | Distributed by Public on 07/26/2024 13:30

Amendment to Beneficial Ownership Report - Form SC 13D/A

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

SCHEDULE 13D/A

Under the Securities Exchange Act of 1934
(Amendment No. 15)*

KAYNE DL 2021, INC.

(Name of Issuer)

Common Stock, $0.001 par value per share

(Title of Class of Securities)

None

(CUSIP Number)

Garon Meikle
Chief Financial Officer

UAW Retiree Medical Benefits Trust

1155 Brewery Park Blvd., Suite 400

Detroit, MI 48207

(313) 324-5900

(Name, Address and Telephone Number of Person
Authorized to Receive Notices and Communications)

July 3, 2024

(Date of Event which Requires Filing of this Statement)

If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box. ¨

Note: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See §240.13d-7 for other parties to whom copies are to be sent.

* The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.

The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

CUSIP No. None 13D
1. NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)

UAW Retiree Medical Benefits Trust
2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(see instructions)
(a) x
(b) ¨
3. SEC USE ONLY
4.

SOURCE OF FUNDS (see instructions)


WC

5.

CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨

6. CITIZENSHIP OR PLACE OF ORGANIZATION

None. Organized as a 501(c)(9) Voluntary Employee Beneficiary Association.
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON WITH
7. SOLE VOTING POWER

0
8.

SHARED VOTING POWER

46,418.1

9. SOLE DISPOSITIVE POWER

0
10. SHARED DISPOSITIVE POWER

46,418.1
11. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

46,418.1
12. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
(see instructions) ¨
13. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

99.1%
14. TYPE OF REPORTING PERSON (see instructions)

EP
CUSIP No. None 13D
1. NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)

UAW Chrysler Retirees Medical Benefits Plan
2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(see instructions)
(a) x
(b) ¨
3. SEC USE ONLY
4. SOURCE OF FUNDS (see instructions)

WC
5.

CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨

6. CITIZENSHIP OR PLACE OF ORGANIZATION

None. Organized as a 501(c)(9) Voluntary Employee Beneficiary Association.
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON WITH
7. SOLE VOTING POWER

0
8.

SHARED VOTING POWER

9,051.5

9. SOLE DISPOSITIVE POWER

0
10. SHARED DISPOSITIVE POWER

9,051.5
11. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

9,051.5
12. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
(see instructions) ¨
13. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

19.3%
14. TYPE OF REPORTING PERSON (see instructions)

EP
CUSIP No. None 13D
1. NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)

UAW Ford Retirees Medical Benefits Plan
2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(see instructions)
(a) x
(b) ¨
3. SEC USE ONLY
4. SOURCE OF FUNDS (see instructions)

WC
5.

CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨

6. CITIZENSHIP OR PLACE OF ORGANIZATION

None. Organized as a 501(c)(9) Voluntary Employee Beneficiary Association.
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON WITH
7. SOLE VOTING POWER

0
8.

SHARED VOTING POWER

14,111.1

9. SOLE DISPOSITIVE POWER

0
10. SHARED DISPOSITIVE POWER

14,111.1
11. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

14,111.1
12. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
(see instructions) ¨
13. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

30.1%
14. TYPE OF REPORTING PERSON (see instructions)

EP
CUSIP No. None 13D
1. NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)

UAW GM Retirees Medical Benefits Plan
2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(see instructions)
(a) x
(b) ¨
3. SEC USE ONLY
4. SOURCE OF FUNDS (see instructions)

WC
5.

CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨

6. CITIZENSHIP OR PLACE OF ORGANIZATION

None. Organized as a 501(c)(9) Voluntary Employee Beneficiary Association.
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON WITH
7. SOLE VOTING POWER

0
8. SHARED VOTING POWER

23,255.4
9. SOLE DISPOSITIVE POWER

0
10. SHARED DISPOSITIVE POWER

23,255.4
11. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

23,255.4
12. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
(see instructions) ¨
13. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

49.6%
14. TYPE OF REPORTING PERSON (see instructions)

EP
CUSIP No. None 13D
1. NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)

Hershel Harper
2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(see instructions)
(a) x
(b) ¨
3. SEC USE ONLY
4.

SOURCE OF FUNDS (see instructions)


AF

5.

CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) or 2(e) ¨

6. CITIZENSHIP OR PLACE OF ORGANIZATION

United States
NUMBER OF
SHARES
BENEFICIALLY
OWNED BY
EACH
REPORTING
PERSON WITH
7. SOLE VOTING POWER

0
8.

SHARED VOTING POWER

46,418.1

9. SOLE DISPOSITIVE POWER

0
10. SHARED DISPOSITIVE POWER

46,418.1
11. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

46,418.1
12. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
(see instructions) ¨
13. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

99.1%
14. TYPE OF REPORTING PERSON (see instructions)

IN
CUSIP No. None 13D

Item 1. Security and Issuer.

This Amendment No. 15 ("Amendment No. 15") amends the statement on Schedule 13D filed with the Securities and Exchange Commission on December 16, 2021 as amended by Amendment No. 1 on December 21, 2021, Amendment No. 2 on June 29, 2022, Amendment No. 3 on October 18, 2022, Amendment No. 4 on December 13, 2022, Amendment No. 5 on January 25, 2023, Amendment No. 6 on March 2, 2023, Amendment No. 7 on April 24, 2023, Amendment No. 8 on July 28, 2023, Amendment No. 9 on August 11, 2023, Amendment No. 10 on October 24, 2023, Amendment No. 11 on December 21, 2023, Amendment No. 12 on January 23, 2024, Amendment No. 13 on February 20, 2024, and Amendment No. 14 on April 23, 2024. This Amendment No. 15 relates to shares of common stock (the "Shares") of Kayne DL 2021, Inc., a Delaware business development company (the "Issuer"). The Issuer's principal executive offices are located at 717 Texas Avenue, Suite 2200, Houston, TX 77002.

Item 4. Purpose of Transaction.

This Item 4 is hereby amended to include the following:

On July 3, 2024, pursuant to drawdown notices delivered in accordance with the Subscription Agreements: (i) UAW Chrysler Retirees Medical Benefits Plan purchased from the Issuer, and the Issuer issued to UAW Chrysler Retirees Medical Benefits Plan, 915.971 Shares; (ii) UAW Ford Retirees Medical Benefits Plan purchased from the Issuer, and the Issuer issued to UAW Ford Retirees Medical Benefits Plan, 1,427.975 Shares; and (iii) UAW GM Retirees Medical Benefits Plan purchased from the Issuer, and the Issuer issued to UAW GM Retirees Medical Benefits Plan, 2,353.340 Shares. The price per Share was $5,269.00. The effective purchase date of these Shares is July 3, 2024, however, the number of Shares purchased was not known until the net asset value of the Issuer was finalized on July 25, 2024.

On July 15, 2024, pursuant to a dividend reinvestment plan: (i) UAW Chrysler Retirees Medical Benefits Plan reinvested dividend proceeds in the Issuer, and the Issuer issued to UAW Chrysler Retirees Medical Benefits Plan, 31.607 Shares; (ii) UAW Ford Retirees Medical Benefits Plan reinvested dividend proceeds in the Issuer, and the Issuer issued to UAW Ford Retirees Medical Benefits Plan, 49.274 Shares; and (iii) UAW GM Retirees Medical Benefits Plan reinvested dividend proceeds in the Issuer, and the Issuer issued to UAW GM Retirees Medical Benefits Plan, 81.205 Shares. The price per Share was $5,269.00. The effective purchase date of these Shares is July 15, 2024, however, the number of Shares purchased was not known until the net asset value of the Issuer was finalized on July 25, 2024.

The purpose of the transaction was to acquire securities of the Issuer for investment purposes.

The Issuer is a business development company. The Reporting Persons expect to continue to beneficially own, in the aggregate, greater than 99% of the Shares outstanding. The investment strategy and investment policy of the Issuer have been devised by, and will be implemented by, KA Credit Advisors II, LLC. The Reporting Persons do not have any plans or proposals to make any changes to the Issuer's investment policy.

The Reporting Persons may change their intention with respect to any and all matters referred to in this Item 4.

Except as set forth herein, the Reporting Persons have no present plan or proposal that would relate to or result in any of the matters set forth in subparagraphs (a)-(j) of Item 4 of Schedule 13D.

Item 5. Interest in Securities of the Issuer.

(a) The aggregate number of Shares to which this Amendment No. 15 relates is 46,418.1. Such aggregate number of Shares represents 99.1% of the common stock of the Issuer. The percentage reported in this Amendment No. 15 is calculated based upon 46,839.55 Shares stated to be outstanding as of July 15, 2024, as indicated by the Issuer.

(b) The UAW Chrysler Retirees Medical Benefits Plan beneficially owns and has shared voting and dispositive power of 9,051.5 Shares. Such Shares represent 19.3% of the Shares outstanding.

The UAW Ford Retirees Medical Benefits Plan beneficially owns and has shared voting and dispositive power of 14,111.1 Shares. Such Shares represent 30.1% of the Shares outstanding.

The UAW GM Retirees Medical Benefits Plan beneficially owns and has shared voting and dispositive power of 23,255.4 Shares. Such Shares represent 49.6% of the Shares outstanding.

CUSIP No. None 13D

UAW RMBT is the trust under which the Plans are established and, pursuant to Rule 13d-3, may be deemed to beneficially own the 46,418.1 Shares held by the Plans. Such Shares represent 99.1% of the Shares outstanding. UAW RMBT is an indirect beneficial owner of these Shares.

Hershel Harper is the chief investment officer of UAW RMBT, the trust under which the Plans are established, and, pursuant to Rule 13d-3 may be deemed to beneficially own the 46,418.1 Shares held by the Plans. Such Shares represent 99.1% of the Shares outstanding. Hershel Harper is an indirect beneficial owner of these Shares.

(c) Except as disclosed in Item 4, no transactions in the Shares were effected during the past sixty days by the Reporting Persons.

(d) Not applicable.

(e) Not applicable.

CUSIP No. None 13D

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Dated: July 26, 2024

UAW RETIREE MEDICAL BENEFITS TRUST
By: /s/ Garon Meikle
Name: Garon Meikle
Title: Chief Financial Officer
UAW CHRYSLER RETIREES MEDICAL BENEFITS PLAN
By: /s/ Garon Meikle
Name: Garon Meikle
Title: Chief Financial Officer
UAW FORD RETIREES MEDICAL BENEFITS PLAN
By: /s/ Garon Meikle
Name: Garon Meikle
Title: Chief Financial Officer
UAW GM RETIREES MEDICAL BENEFITS PLAN
By: /s/ Garon Meikle
Name: Garon Meikle
Title: Chief Financial Officer
HERSHEL HARPER
/s/ Hershel Harper