John Thimsen - 01 Feb 2021 Form 4/A - Amendment Insider Report for Qualtrics International Inc.

Role
Chief Technology Officer
Signature
/s/ Blake Tierney, Attorney-in-Fact
Issuer symbol
N/A
Transactions as of
01 Feb 2021
Net transactions value
$0
Form type
4/A - Amendment
Filing time
05 Oct 2021, 20:41:29 UTC
Date Of Original Report
02 Feb 2021
Next filing
07 May 2021
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction XM Class A Common Stock Award +288,289 288,289 01 Feb 2021 Direct F1
transaction XM Class A Common Stock Award +52,652 +18% 340,941 01 Feb 2021 Direct F2, F3
transaction XM Class A Common Stock Award +833,333 +244% 1,174,274 01 Feb 2021 Direct F3, F4
transaction XM Class A Common Stock Award +33,367 +2.8% 1,207,641 01 Feb 2021 Direct F3, F5
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 On February 2, 2021, the Reporting Person filed a Form 4 erroneously reporting an acquisition of 288,290, instead of 288,289, restricted stock units ("RSUs") with respect to Class A common stock granted to the Reporting Person in exchange for cash-settled restricted stock units with respect to SAP SE stock tendered in the exchange offer in connection with the initial public offering of the Registrant's Class A common stock (the "Exchange Offer"). These RSUs continue to vest in equal annual installments, in accordance with the vesting terms of the original awards that were tendered in the Exchange Offer.
F2 Represents RSUs with respect to Class A common stock granted to the Reporting Person in exchange for cash-settled restricted stock units with respect to SAP SE stock tendered in the Exchange Offer. These RSUs continue to vest in equal annual installments, in accordance with the vesting terms of the original awards that were tendered in the Exchange Offer.
F3 The Form 4 filed on February 2, 2021 is amended to correct the number of shares beneficially owned following the transaction.
F4 Represents RSUs granted under the 2021 Qualtrics International Inc. Employee Omnibus Equity Plan (the "2021 Plan"). These RSUs vest 25% on the first anniversary of the grant date and ratably thereafter in 12 equal quarterly installments.
F5 Represents RSUs granted under the 2021 Plan. These RSUs vest in 16 equal quarterly installments.