SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Williams Teri

(Last) (First) (Middle)
C/O CCC INTELLIGENT SOLUTIONS HOLDINGS
167 N. GREEN STREET, 9TH FLOOR

(Street)
CHICAGO IL 60607

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CCC Intelligent Solutions Holdings Inc. [ CCCS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
05/23/2024
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 05/23/2024 M 24,109 A $11.67 74,135 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Unit(1) $0 05/23/2024 M 24,109 (1) (1) Common Stock 24,109 $0 0 D
Restricted Stock Unit(2) $0 05/23/2024 A 21,423 (2) (2) Common Stock 21,423 $0 21,423 D
Explanation of Responses:
1. The Reporting Person was granted Restricted Stock Units ("RSUs") which represent a contingent right to receive, at the Issuer's discretion, (i) one share of Common Stock for each RSU, (ii) an amount of cash equal to the fair market value of such share of Common Stock on the date immediately preceding the date of settlement of the RSU, or (iii) a combination thereof. The RSUs vest on the earlier of May 25, 2024 and the date of the next annual meeting of the stockholders of the Issuer, generally subject to the Reporting Person's continued service to the Issuer through such vesting and settlement date.
2. The Reporting Person was granted Restricted Stock Units ("RSUs") which represent a contingent right to receive, at the Issuer's discretion, (i) one share of Common Stock for each RSU, (ii) an amount of cash equal to the fair market value of such share of Common Stock on the date immediately preceding the date of settlement of the RSU, or (iii) a combination thereof. The RSUs vest on the earlier of May 23, 2025 and the date of the next annual meeting of the stockholders of the Issuer, generally subject to the Reporting Person's continued service to the Issuer through such vesting and settlement date.
/s/ Kevin Kane as Attorney-in-Fact for Teri Williams 05/24/2024
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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