0001209191-21-019672.txt : 20210310 0001209191-21-019672.hdr.sgml : 20210310 20210310211026 ACCESSION NUMBER: 0001209191-21-019672 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201208 FILED AS OF DATE: 20210310 DATE AS OF CHANGE: 20210310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HOUSE PATRICIA A CENTRAL INDEX KEY: 0001241633 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-39744 FILM NUMBER: 21731567 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 3/A 1 doc3a.xml FORM 3/A SUBMISSION X0206 3/A 2020-12-08 2020-12-08 0 0001577526 C3.ai, Inc. AI 0001241633 HOUSE PATRICIA A C/O C3.AI, INC. 1300 SEAPORT BLVD, SUITE 500 REDWOOD CITY CA 94063 1 0 0 0 Class A Common Stock 89730 D Class A Common Stock 397193 I See Footnote The shares are held by the Patricia A. House 2020 2 Year GRAT created UTA dated September 22, 2020, of which the Reporting Person is trustee. This amendment is being filed to correctly reflect the shares held directly and indirectly. /s/ Brady Mickelsen, Attorney-in-Fact 2021-03-10