Chrysler Retireees Medical Benefits Plan UAW Form 4 Kayne DL 2021 / GM RETIREES MEDICAL BENEFITS PLAN UAW ownership change

SEC Form 4

FORM 4

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

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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

OMB APPROVAL

OMB Number:	3235-0287
Estimated average burden
hours per response:	0.5

Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

UAW Chrysler Retirees Medical Benefits Plan

(Last) (First) (Middle)

C/O UAW RETIREE MEDICAL BENEFITS TRUST

1155 BREWERY PARK BLVD., SUITE 400

(Street)

DETROIT MI 48207

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
Kayne DL 2021, Inc. [ NONE ]

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

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

3. Date of Earliest Transaction (Month/Day/Year)
07/03/2024

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

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

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

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
			Code	V	Amount	(A) or (D)	Price
Common Stock	07/03/2024(1)		P		915.971	A	$5,269	9,019.911	D(2)
Common Stock	07/03/2024		P		1,427.975	A	$5,269	14,061.815	D(3)
Common Stock	07/03/2024		P		2,353.34	A	$5,269	23,174.24	D(4)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
				Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares

1. Name and Address of Reporting Person^*

UAW Chrysler Retirees Medical Benefits Plan

(Last) (First) (Middle)

C/O UAW RETIREE MEDICAL BENEFITS TRUST

1155 BREWERY PARK BLVD., SUITE 400

(Street)

DETROIT MI 48207

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

UAW Ford Retirees Medical Benefits Plan

(Last) (First) (Middle)

C/O UAW RETIREE MEDICAL BENEFITS TRUST

1155 BREWERY PARK BLVD., SUITE 400

(Street)

DETROIT MI 48207

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

UAW GM RETIREES MEDICAL BENEFITS PLAN

(Last) (First) (Middle)

C/O UAW RETIREE MEDICAL BENEFITS TRUST

1155 BREWERY PARK BLVD., SUITE 400

(Street)

DETROIT MI 48207

(City) (State) (Zip)

Explanation of Responses:

1. The effective purchase date of these shares of common stock (the "Shares") of Kayne DL 2021, Inc. (the "Issuer") 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.

2. These Shares of the Issuer are owned directly by the UAW Chrysler Retirees Medical Benefits Plan, as established and maintained by the UAW Chrysler Retirees Employees' Beneficiary Association, an employee organization within the meaning of Section 3(4) of the Employee Retirement Income Security Act of 1974, as amended ("ERISA") under the UAW Retiree Medical Benefits Trust, organized as a 501(c)(9) Voluntary Employee Beneficiary Association (the "UAW RMBT").

3. These Shares of the Issuer are owned directly by the UAW Ford Retirees Medical Benefits Plan, as established and maintained by the UAW Ford Retirees Employees' Beneficiary Association, an employee organization within the meaning of Section 3(4) of ERISA under the UAW RMBT.

4. These Shares of the Issuer are owned directly by the UAW GM Retirees Medical Benefits Plan, as established and maintained by the UAW GM Retirees Employees' Beneficiary Association, an employee organization within the meaning of Section 3(4) of ERISA under the UAW RMBT.

	UAW CHRYSLER RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Chief Financial Officer	07/26/2024
	UAW FORD RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Chief Financial Officer	07/26/2024
	UAW GM RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Chief Financial Officer	07/26/2024
	** 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 4 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.