Zig Serafin - 01 Feb 2023 Form 4 Insider Report for Qualtrics International Inc.

Reporting relationship: Chief Executive Officer, Director
Issuer ticker: N/A
Reported as of: 01 Feb 2023
Net transaction value: $0
SEC form: 4
Accepted by SEC: 03 Feb 2023, 19:01:17 UTC
Prior SEC filing: 03 Nov 2022
Next SEC filing: 13 Feb 2023
Source filing: View source filing
Reporting owner signature: /s/ Blake Tierney, Attorney-in-Fact

Key filing fact

Zig Serafin filed Form 4 for Qualtrics International Inc. on 03 Feb 2023.

Key facts

This page summarizes Zig Serafin's Form 4 filing for Qualtrics International Inc..
1 reported transaction and 0 derivative rows are listed below.
Accepted by SEC: 03 Feb 2023, 19:01.

Change

Previous filing in this sequence was filed on 03 Nov 2022.
Current net transaction value: $0.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

XM transaction

Class A Common Stock

Award

Transaction value
Shares: +1,500,000
Change %: +14%
Price
Shares after: 12,496,949
Date: 01 Feb 2023
Ownership: Direct
Footnotes: F1

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 1 footnote

Footnote 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.