John Ellis Bush Form 3 Jackson Acquisition / John Ellis Bush ownership change

SEC Form 3

FORM 3

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

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Bush John Ellis

(Last) (First) (Middle)

C/O JACKSON ACQUISITION COMPANY

2655 NORTHWINDS PARKWAY

(Street)

ALPHARETTA GA 30009

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
12/08/2021

3. Issuer Name and Ticker or Trading Symbol
Jackson Acquisition Co [ RJAC ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
	Date Exercisable	Expiration Date	Title	Amount or Number of Shares

Explanation of Responses:

Remarks:

Exhibit 24.1 - Power of Attorney Mr. Bush does not beneficially own any shares of common stock of the issuer. However, Mr. Bush has an interest in shares of Class B common stock through his membership interest in RJ Healthcare SPAC, LLC (the "Sponsor"). He is also one of the managing members of the Sponsor; however, Richard L. Jackson, President and Chief Executive Officer of the issuer, exercises ultimate voting and dispositive control over the securities held by the Sponsor. Mr. Bush disclaims beneficial ownership over any securities owned by the Sponsor in which he does not have any pecuniary interest.

No securities are beneficially owned.

	/s/ Richard L. Jackson, as attorney-in fact for John Ellis Bush	12/08/2021
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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