Ryan S. Smith - Feb 1, 2023 Form 4 Insider Report for Qualtrics International Inc. (XM)

Role: Founder and Executive Chair, Director
Signature: /s/ Blake Tierney, Attorney-in-Fact
Stock symbol: XM
Transactions as of: Feb 1, 2023
Transactions value $: $0
Form type: 4
Date filed: 2/3/2023, 07:01 PM
Previous filing: Nov 3, 2022
Next filing: Feb 13, 2023

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	XM	Class A Common Stock	Award		+1.5M	+12.83%		13.2M	Feb 1, 2023	Direct	F1, F2
holding	XM	Class A Common Stock						6M	Feb 1, 2023	By Q II, LLC

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	Represents the number of performance stock units ("PSUs") granted under the 2021 Qualtrics International Inc. Employee Omnibus Equity Plan which vested on February 1, 2023. The extent to which these PSUs vest is conditional upon the achievement of objectives set and approved by the Board. To the extent these objectives are met on an annual basis, these PSUs vest 25% on the first anniversary of the grant date and ratably thereafter in 3 equal annual installments.
F2	Includes 1,064 shares acquired under the 2021 Qualtrics International Inc. Employee Stock Purchase Plan on January 31, 2023.

Content

Represents the number of performance stock units ("PSUs") granted under the 2021 Qualtrics International Inc. Employee Omnibus Equity Plan which vested on February 1, 2023. The extent to which these PSUs vest is conditional upon the achievement of objectives set and approved by the Board. To the extent these objectives are met on an annual basis, these PSUs vest 25% on the first anniversary of the grant date and ratably thereafter in 3 equal annual installments.

Includes 1,064 shares acquired under the 2021 Qualtrics International Inc. Employee Stock Purchase Plan on January 31, 2023.