0001209191-21-039305.txt : 20210609 0001209191-21-039305.hdr.sgml : 20210609 20210609195740 ACCESSION NUMBER: 0001209191-21-039305 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210607 FILED AS OF DATE: 20210609 DATE AS OF CHANGE: 20210609 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SIEBEL THOMAS M CENTRAL INDEX KEY: 0001031530 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39744 FILM NUMBER: 211006543 MAIL ADDRESS: STREET 1: SIEBEL SYSTEMS INC STREET 2: 2207 BRIDGEPOINTE PARKWAY CITY: SAN MATEO STATE: CA ZIP: 94404 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Siebel Living Trust u/a/d 7/27/93, as amended CENTRAL INDEX KEY: 0001834425 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39744 FILM NUMBER: 211006542 BUSINESS ADDRESS: STREET 1: C/O C3.AI, INC. STREET 2: 1300 SEAPORT BLVD., SUITE 500 CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-503-2200 MAIL ADDRESS: STREET 1: C/O C3.AI, INC. STREET 2: 1300 SEAPORT BLVD., SUITE 500 CITY: REDWOOD CITY STATE: CA ZIP: 94063 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: C3.ai, Inc. CENTRAL INDEX KEY: 0001577526 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 263999357 STATE OF INCORPORATION: DE FISCAL YEAR END: 0430 BUSINESS ADDRESS: STREET 1: 1300 SEAPORT BLVD STREET 2: SUITE 500 CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-503-2218 MAIL ADDRESS: STREET 1: 1300 SEAPORT BLVD STREET 2: SUITE 500 CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: C3 IoT, Inc. DATE OF NAME CHANGE: 20180123 FORMER COMPANY: FORMER CONFORMED NAME: C3, Inc. DATE OF NAME CHANGE: 20130522 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-06-07 0 0001577526 C3.ai, Inc. AI 0001031530 SIEBEL THOMAS M C/O C3.AI, INC. 1300 SEAPORT BLVD, SUITE 500 REDWOOD CITY CA 94603 1 1 1 0 Chief Executive Officer 0001834425 Siebel Living Trust u/a/d 7/27/93, as amended C/O C3.AI, INC. 1300 SEAPORT BLVD, SUITE 500 REDWOOD CITY CA 94063 0 0 1 0 Class A Common Stock 2021-06-07 4 S 0 424991 60.05 D 8814481 I See Footnote Class A Common Stock 2021-06-07 4 S 0 73367 61.34 D 8741114 I See Footnote Class A Common Stock 2021-06-07 4 S 0 1642 62.00 D 8739472 I See Footnote Class A Common Stock 2021-06-08 4 S 0 265269 62.87 D 8474203 I See Footnote Class A Common Stock 2021-06-08 4 S 0 351741 64.06 D 8122462 I See Footnote Class A Common Stock 2021-06-08 4 S 0 32990 64.51 D 8089472 I See Footnote Class A Common Stock 2021-06-09 4 S 0 121514 64.55 D 7967958 I See Footnote Class A Common Stock 2021-06-09 4 S 0 22842 65.07 D 7945116 I See Footnote Class A Common Stock 1756390 D Class A Common Stock 9216 I See Footnote Class A Common Stock 170294 I See Footnote Class A Common Stock 72695 I See Footnote Class A Common Stock 1237115 I See Footnote Class B Common Stock 2021-03-31 5 G 0 E 43047 0.00 D Class A Common Stock 43047 0 I See Footnote Class B Common Stock 2021-03-31 5 G 0 E 43047 0.00 D Class A Common Stock 43047 0 I See Footnote Class B Common Stock 2021-06-07 5 G 0 E 1217 0.00 D Class A Common Stock 1217 17792 I See Footnote Class B Common Stock 2021-06-07 5 G 0 E 1217 0.00 D Class A Common Stock 1217 17792 I See Footnote Class B Common Stock 2021-06-07 5 G 0 E 2434 0.00 A Class A Common Stock 2434 2035182 I See Footnote Class B Common Stock Class A Common Stock 500000 500000 I See Footnote Class B Common Stock Class A Common Stock 82109 82109 I See Footnote Class B Common Stock Class A Common Stock 82109 82109 I See Footnote Class B Common Stock Class A Common Stock 23758 23758 I See Footnote Class B Common Stock Class A Common Stock 23758 23758 I See Footnote Class B Common Stock Class A Common Stock 18353 18353 I See Footnote Class B Common Stock Class A Common Stock 18353 18353 I See Footnote Class B Common Stock Class A Common Stock 10250 10250 I See Footnote Class B Common Stock Class A Common Stock 10250 10250 I See Footnote Represents weighted average sales price. The shares were sold at prices ranging from $60.00 to $60.96. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. The shares are held by The Siebel Living Trust u/a/d 7/27/93, a amended, of which the Reporting Person is trustee. Represents weighted average sales price. The shares were sold at prices ranging from $61.00 to $61.98. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $62.50 to $63.49. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $63.50 to $64.47. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $64.50 to $64.60. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $64.00 to $64.98. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $65.00 to $65.14. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. The shares are held by First Virtual Holdings, LLC, of which the Reporting Person is Chairman. The shares are held by Siebel Asset Management, L.P., of which the Reporting Person is the general partner. The shares are held by Siebel Asset Management III, L.P., of which the Reporting Person is the general partner. The shares are held by The Siebel 2011 Irrevocable Children's Trust, of which the Reporting Person is co-trustee. Each share of Class B Common Stock is convertible at any time at the option of the holder into one share of Class A Common Stock. On March 31, 2021, shares held by the annuity trust were transferred to the beneficiaries of the trust to satisfy annuity payments. The shares were held by The Siebel 2013 Annuity Trust I u/a/d 10/8/2013, of which the Reporting Person is the trustee. The shares were held by The Siebel 2013 Annuity Trust II u/a/d 10/8/2013, of which the Reporting Person is the trustee. On June 7, 2021, shares held by the annuity trust were transferred to The Siebel Living Trust u/a/d 7/27/1983 to satisfy annuity payments. The shares are held by The Siebel 2020 Annuity Trust I u/a/d 3/4/2020, of which the Reporting Person is the trustee. The shares are held by The Siebel 2020 Annuity Trust II u/a/d 3/4/2020, of which the Reporting Person is the trustee. On June 7, 2021, these shares that were held by related annuity trusts were transferred to The Siebel Living Trust u/a/d 7/27/1983 to satisfy annuity payments. The shares are held by The Siebel 2014 Annuity Trust I u/a/d 10/22/2014, of which the Reporting Person is the trustee. The shares are held by The Siebel 2014 Annuity Trust II u/a/d 10/22/2014, of which the Reporting Person is the trustee. The shares are held by The Siebel 2017 Annuity Trust I u/a/d 11/28/2017, of which the Reporting Person is the trustee. The shares are held by The Siebel 2017 Annuity Trust II u/a/d 11/28/2017, of which the Reporting Person is the trustee. The shares are held by The Siebel 2018 Annuity Trust I u/a/d 12/13/2018, of which the Reporting Person is the trustee. Previous Form 4 filed on March 10, 2021 contained a typo in the amount of securities beneficially owned. This amount has been corrected in this Form 4. The shares are held by The Siebel 2018 Annuity Trust II u/a/d 12/18/2018, of which the Reporting Person is the trustee. The shares are held by The Siebel 2020 Annuity Trust III u/a/d 12/3/2020, of which the Reporting Person is the trustee. The shares are held by The Siebel 2020 Annuity Trust IV u/a/d 12/3/2020, of which the Reporting Person is the trustee. /s/ Brady Mickelsen, Attorney-in-Fact 2021-06-09 /s/ Brady Mickelsen, Attorney-in-Fact 2021-06-09