Statement of Changes in Beneficial Ownership (4)
27 Março 2023 - 5:22PM
Edgar (US Regulatory)
FORM 4
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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).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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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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1. Name and Address of Reporting Person
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PRIGGE MARY JO |
2. Issuer Name and Ticker or Trading Symbol
CCC Intelligent Solutions Holdings Inc.
[
CCCS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) See Remarks |
(Last)
(First)
(Middle)
C/O CCC INTELLIGENT SOLUTIONS HOLDINGS, 167 N. GREEN STREET, 9TH FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/23/2023 |
(Street)
CHICAGO, IL 60607 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | | | | | | | | 853085 | I | By Trust |
Common Stock | 3/23/2023 | | M | | 17722 | A | $0 | 17722 | D | |
Common Stock | 3/23/2023 | | F | | 5193 | D | $8.70 | 12529 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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 | 3/23/2023 | | M | | | 17722 | (1) | (1) | Common Stock | 17722 | $0 | 53167 | 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. Twenty-five percent (25%) of the RSUs vest upon each of the first four anniversaries of the Grant Date, generally subject to the Reporting Person's continued service to the Issuer through each such vesting and settlement date. |
Remarks: Executive Vice President, Chief Service Delivery Officer |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
PRIGGE MARY JO C/O CCC INTELLIGENT SOLUTIONS HOLDINGS 167 N. GREEN STREET, 9TH FLOOR CHICAGO, IL 60607 |
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| See Remarks |
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Signatures
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/s/ Kevin Kane as Attorney-in-Fact for Mary Jo Prigge | | 3/27/2023 |
**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. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
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