0001562180-23-005525.txt : 20230628
0001562180-23-005525.hdr.sgml : 20230628
20230628163547
ACCESSION NUMBER: 0001562180-23-005525
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230626
FILED AS OF DATE: 20230628
DATE AS OF CHANGE: 20230628
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Stucki Brian
CENTRAL INDEX KEY: 0001954798
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39952
FILM NUMBER: 231052743
MAIL ADDRESS:
STREET 1: C/O QUALTRICS INTERNATIONAL INC.
STREET 2: 333 WEST RIVER PARK DRIVE
CITY: PROVO
STATE: UT
ZIP: 84604
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Qualtrics International Inc.
CENTRAL INDEX KEY: 0001747748
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 471754215
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 333 WEST RIVER PARK DRIVE
CITY: PROVO
STATE: UT
ZIP: 84604
BUSINESS PHONE: 385-203-4999
MAIL ADDRESS:
STREET 1: 333 WEST RIVER PARK DRIVE
CITY: PROVO
STATE: UT
ZIP: 84604
4
1
primarydocument.xml
PRIMARY DOCUMENT
X0407
4
2023-06-26
false
0001747748
Qualtrics International Inc.
XM
0001954798
Stucki Brian
333 WEST RIVER PARK DRIVE
PROVO
UT
84604
false
true
false
false
See Remarks
true
Class A Common Stock
2023-06-26
4
S
false
12000.00
18.14
D
596788.00
D
The sale reported in this Form 4 was effectuated pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person on December 14, 2021.
President and Chief Operating Officer
/s/ Blake Tierney, Attorney-in-Fact
2023-06-28