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Filing Details

Accession Number:: 0000899243-22-010323
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2022-03-09 19:51:48
Reporting Period:: 2022-03-07

Accepted Time:: 2022-03-09 19:51:48
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1747748	Qualtrics International Inc.	XM	()	DE

Insiders

Cik	Name	Reported Address	Director	Officer	Large Shareholder	Other
1418226	Silver Lake Group, L.l.c.	C/O Silver Lake 2775 Sand Hill Road, Suite 100 Menlo Park CA 94025	Yes	No	Yes	No
1651403	Egon Durban	C/O Silver Lake 2775 Sand Hill Road, Suite 100 Menlo Park CA 94025	Yes	No	No	No
1830249	Silver Lake Technology Associates Vi, L.p.	C/O Silver Lake 2775 Sand Hill Road, Suite 100 Menlo Park CA 94025	Yes	No	Yes	No
1830356	Slta Vi (Gp), L.l.c.	C/O Silver Lake 2775 Sand Hill Road, Suite 100 Menlo Park CA 94025	Yes	No	Yes	No
1850029	Silver Lake Partners Vi De (Aiv), L.p.	C/O Silver Lake 2775 Sand Hill Road, Suite 100 Menlo Park CA 94025	Yes	No	Yes	No
1850130	L.p. Vi Investors Technology Lake Silver	C/O Silver Lake 2775 Sand Hill Road, Suite 100 Menlo Park CA 94025	Yes	No	Yes	No

Reported Non-Derivative Transactions

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Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Class A Common Stock	Acquisiton	2022-03-07	98,544	$26.48	1,989,756	No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
Class A Common Stock	Acquisiton	2022-03-07	7,875	$26.48	159,007	No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
Class A Common Stock	Acquisiton	2022-03-07	16,058	$27.05	2,005,814	No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
Class A Common Stock	Acquisiton	2022-03-07	1,283	$27.05	160,290	No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
Class A Common Stock	Acquisiton	2022-03-08	30,622	$26.13	2,036,436	No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
Class A Common Stock	Acquisiton	2022-03-08	2,447	$26.13	162,737	No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
Class A Common Stock	Acquisiton	2022-03-08	64,467	$27.37	2,100,903	No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
Class A Common Stock	Acquisiton	2022-03-08	5,152	$27.37	167,889	No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
Class A Common Stock	Acquisiton	2022-03-08	18,102	$27.71	2,119,005	No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
Class A Common Stock	Acquisiton	2022-03-08	1,446	$27.71	169,335	No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
Class A Common Stock	Acquisiton	2022-03-09	7,818	$28.75	2,126,823	No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
Class A Common Stock	Acquisiton	2022-03-09	625	$28.75	169,960	No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.
No	4	P	Indirect	Held through Silver Lake Partners VI DE (AIV), L.P.
No	4	P	Indirect	Held through Silver Lake Technology Investors VI, L.P.

Reported Non-Derivative Holdings

Sec. Name	Remaning Holdings	Nature of Ownership	Explanation
Class A Common Stock	22,518,484	Indirect	Held through SLP Quartz Aggregator, L.P.

Footnotes

Represents securities held by Silver Lake Partners VI DE (AIV), L.P. ("SLP VI").
Represents securities held by Silver Lake Technology Investors VI, L.P. ("SLTI VI").
Represents securities held by SLP Quartz Aggregator, L.P. ("SLP Quartz"). SLP VI Aggregator GP, L.L.C. ("SLP VI GP") is the general partner of SLP Quartz.
Silver Lake Technology Associates VI, L.P. ("SLTA VI") is the general partner of each of SLP VI and SLTI VI and the managing member of SLP VI GP. SLTA VI (GP), L.L.C. ("SLTA VI GP") is the general partner of SLTA VI. Silver Lake Group, L.L.C. ("SLG") is the managing member of SLTA VI GP. Mr. Egon Durban serves as a member of the board of directors of Qualtrics International Inc. (the "Issuer") and is Co-CEO and Managing Member of SLG. Each of SLP VI, SLTI VI, SLP Quartz, SLP VI GP, SLTA VI, SLTA VI GP and SLG may be deemed to be a director by deputization of the Issuer.
Represents shares of Class A common stock purchased in multiple transactions at prices ranging from $25.95 to $26.94. The price reported is a weighted average price. The Reporting Persons undertake to provide to the Issuer, any security holder of the Issuer, or the Staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares of Class A common stock purchased at each separate price within the range set forth in the footnotes to this Form 4.
Represents shares of Class A common stock purchased in multiple transactions at prices ranging from $26.95 to $27.29. The price reported is a weighted average price.
Represents shares of Class A common stock purchased in multiple transactions at prices ranging from $25.65 to $26.64. The price reported is a weighted average price.
Represents shares of Class A common stock purchased in multiple transactions at prices ranging from $26.65 to $27.64. The price reported is a weighted average price.
Represents shares of Class A common stock purchased in multiple transactions at prices ranging from $27.65 to $27.84. The price reported is a weighted average price.
Represents shares of Class A common stock purchased in multiple transactions at prices ranging from $28.18 to $29.00. The price reported is a weighted average price.