SEC FORM 3 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*
Vickers Venture Fund VI Pte Ltd

(Last) (First) (Middle)
C/O VICKERS VANTAGE CORP. I
1 HARBOURFRONT AVENUE, #16-06

(Street)
SINGAPORE U0 098632

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/06/2021
3. Issuer Name and Ticker or Trading Symbol
Vickers Vantage Corp. I [ VCKAU ]
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)
Ordinary Shares 3,054,499(1) I By Vickers Venture Fund VI Pte Ltd(2)
Ordinary Shares 320,501(3) I By Vickers Venture Fund VI (Plan) Pte Ltd(4)
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
Warrants (5) (6) Ordinary Shares 5,973,000(7) 11.5 I By Vickers Venture Fund VI Pte Ltd(2)
Warrants (5) (6) Ordinary Shares 627,000(7) 11.5 I By Vickers Venture Fund VI (Plan) Pte Ltd(4)
1. Name and Address of Reporting Person*
Vickers Venture Fund VI Pte Ltd

(Last) (First) (Middle)
C/O VICKERS VANTAGE CORP. I
1 HARBOURFRONT AVENUE, #16-06

(Street)
SINGAPORE U0 098632

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Vickers Venture Fund VI (Plan) Pte Ltd

(Last) (First) (Middle)
C/O VICKERS VANTAGE CORP. I
1 HARBOURFRONT AVENUE, #16-06

(Street)
SINGAPORE U0 098632

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Chi Jeffrey

(Last) (First) (Middle)
C/O VICKERS VANTAGE CORP. I
1 HARBOURFRONT AVENUE, #16-06

(Street)
SINGAPORE U0 098632

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Ho Chris

(Last) (First) (Middle)
C/O VICKERS VANTAGE CORP. I
1 HARBOURFRONT AVENUE, #16-06

(Street)
SINGAPORE U0 098632

(City) (State) (Zip)
Explanation of Responses:
1. Includes up to 407,267 ordinary shares that may be forfeited if the underwriters in the Issuer's initial public offering do not exercise the overallotment option in full.
2. These securities are owned directly by Vickers Venture Fund VI Pte Ltd, a ten percent owner of the Issuer, and indirectly by its managing members, Jeffrey Chi, the Issuer's Chief Executive Officer, and Christopher Ho, the Issuer's Chief Financial Officer. Each of Mr. Chi and Mr. Ho disclaims beneficial ownership of the securities held by Vickers Venture Fund VI Pte Ltd, except to the extent of his pecuniary interest therein.
3. Includes up to 42,733 ordinary shares that may be forfeited if the underwriters in the Issuer's initial public offering do not exercise the overallotment option in full.
4. These securities are owned directly by Vickers Venture Fund VI (Plan) Pte Ltd and indirectly by its managing members, Jeffrey Chi, the Issuer's Chief Executive Officer, and Christopher Ho, the Issuer's Chief Financial Officer. Each of Mr. Chi and Mr. Ho disclaims beneficial ownership of the securities held by Vickers Venture Fund VI (Plan) Pte Ltd, except to the extent of his pecuniary interest therein.
5. Each warrant will become exercisable on the later of the completion of an initial business combination and January 11, 2022.
6. Each warrant will expire five years after the completion of an initial business combination.
7. Represents warrants which, prior to the effective date of the registration statement relating to the Issuer's initial public offering, Vickers Venture Fund VI Pte Ltd and Vickers Venture Fund VI (Plan) Pte Ltd irrevocably committed to purchase. Does not include up to 240,000 warrants which such entities irrevocably committed to purchase in the event the underwriters in the Issuer's initial public offering exercises the overallotment option in full.
Remarks:
Vickers Venture Fund VI Pte Ltd, by Jeffrey Chi, Managing Member 01/06/2021
Vickers Venture Fund VI (Plan) Pte Ltd, by Jeffrey Chi, Managing Member 01/06/2021
/s/ Jeffrey Chi 01/06/2021
/s/ Christopher Ho 01/06/2021
** 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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