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

Role
Chief Revenue 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
03 Feb 2023, 18:37:21 UTC
Date Of Original Report
02 Feb 2021
Next filing
03 Feb 2022
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 +78,980 78,980 01 Feb 2021 Direct F1
transaction XM Class A Common Stock Award +48,067 +61% 127,047 01 Feb 2021 Direct F2
transaction XM Class A Common Stock Award +333,333 +262% 460,380 01 Feb 2021 Direct F3
transaction XM Class A Common Stock Award +66,667 +14% 527,047 01 Feb 2021 Direct F4, 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 78,981, instead of 78,980, 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. The overstatement was carried forward on the Reporting Person's subsequently filed Forms 4.
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 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.
F4 Represents RSUs granted under the 2021 Plan. These RSUs vest in 16 equal quarterly installments.
F5 The Form 4 filed on February 2, 2021 is amended to correct the number of shares beneficially owned following the transaction.