Home/Filings/4/A/0001562180-21-006336
4/A//SEC Filing

Thimsen John 4/A

Accession 0001562180-21-006336

CIK 0001747748other

Filed

Oct 4, 8:00 PM ET

Accepted

Oct 5, 8:41 PM ET

Size

11.1 KB

Accession

0001562180-21-006336

Insider Transaction Report

Form 4/AAmended
Period: 2021-02-01
Thimsen John
Chief Technology Officer
Transactions
  • Award

    Class A Common Stock

    2021-02-01+52,652340,941 total
  • Award

    Class A Common Stock

    2021-02-01+833,3331,174,274 total
  • Award

    Class A Common Stock

    2021-02-01+33,3671,207,641 total
  • Award

    Class A Common Stock

    2021-02-01+288,289288,289 total
Footnotes (5)
  • [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.

Issuer

Qualtrics International Inc.

CIK 0001747748

Entity typeother

Related Parties

1
  • filerCIK 0001842163

Filing Metadata

Form type
4/A
Filed
Oct 4, 8:00 PM ET
Accepted
Oct 5, 8:41 PM ET
Size
11.1 KB