Kayne DL 2021 Form 3 Kayne DL 2021 / HERSHEL HARPER 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^*

UAW Retiree Medical Benefits Trust

(Last) (First) (Middle)

1155 BREWERY PARK BLVD., SUITE 400

(Street)

DETROIT MI 48207

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
12/16/2021

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

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

Director	X	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)

	Form filed by One Reporting Person
X	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)
Common Stock	115.83	D(1)
Common Stock	180.576	D(2)
Common Stock	297.594	D(3)

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

1. Name and Address of Reporting Person^*

UAW Retiree Medical Benefits Trust

(Last) (First) (Middle)

1155 BREWERY PARK BLVD., SUITE 400

(Street)

DETROIT MI 48207

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

UAW Chrysler Retireees 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 Retireees 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)

1. Name and Address of Reporting Person^*

HARPER HERSHEL

(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. These Shares are owned directly by the UAW Chrysler Retirees Medical Benefits Plan. The UAW Chrysler Retirees Medical Benefits Plan is an employee welfare benefit plan established under the UAW RMBT. Hershel Harper is the Chief Investment Officer of the UAW RMBT. The UAW RMBT is deemed to be the indirect beneficial owner of these Shares by reason of its ability to direct the vote and/or disposition of such Shares. The UAW RMBT does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Securities Exchange Act of 1934, as amended (the "Exchange Act")). Hershel Harper is deemed to be the indirect beneficial owner of these Shares by reason of his ability to direct the vote and/or disposition of such Shares. Hershel Harper does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act).

2. These Shares are owned directly by the UAW Ford Retirees Medical Benefits Plan. The UAW Ford Retirees Medical Benefits Plan is an employee welfare benefit plan established under the UAW RMBT. Hershel Harper is the Chief Investment Officer of the UAW RMBT. The UAW RMBT is deemed to be the indirect beneficial owner of these Shares by reason of its ability to direct the vote and/or disposition of such Shares. The UAW RMBT does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act). Hershel Harper is deemed to be the indirect beneficial owner of these Shares by reason of his ability to direct the vote and/or disposition of such Shares. Hershel Harper does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act).

3. These Shares are owned directly by the UAW GM Retirees Medical Benefits Plan. The UAW GM Retirees Medical Benefits Plan is an employee welfare benefit plan established under the UAW RMBT. Hershel Harper is the Chief Investment Officer of the UAW RMBT. The UAW RMBT is deemed to be the indirect beneficial owner of these Shares by reason of its ability to direct the vote and/or disposition of such Shares. The UAW RMBT does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act). Hershel Harper is deemed to be the indirect beneficial owner of these Shares by reason of his ability to direct the vote and/or disposition of such Shares. Hershel Harper does not have a pecuniary interest in such Shares (within the meaning of Rule 16a-1(a)(2) under the Exchange Act).

Remarks:

This Form 3 is being filed by (i) UAW Retiree Medical Benefits Trust, organized as a 501(c)(9) Voluntary Employee Beneficiary Association (the "UAW RMBT"); (ii) 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 RMBT (the "UAW Chrysler Retirees Medical Benefits Plan"); (iii) 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 (the "UAW Ford Retirees Medical Benefits Plan"); (iv) 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 (the "UAW GM Retirees Medical Benefits Plan"); and (v) Hershel Harper, a United States citizen and the Chief Investment Officer of the Trust (collectively, the "Reporting Persons"). The Reporting Persons are members of a group that owns more than 10% of the common stock (the "Shares") of Kayne DL 2021, Inc. (the "Issuer").

	UAW RETIREE MEDICAL BENEFITS TRUST By: /s/ Garon Meikle Name: Garon Meikle Title: Controller	12/16/2021
	UAW CHRYSLER RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Controller	12/16/2021
	UAW FORD RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Controller	12/16/2021
	UAW GM RETIREES MEDICAL BENEFITS PLAN By: /s/ Garon Meikle Name: Garon Meikle Title: Controller	12/16/2021
	HERSHEL HARPER /s/ Hershel Harper	12/16/2021
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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