SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Weber Steven P.

(Last) (First) (Middle)
5 WEST MENDENHALL
SUITE 105

(Street)
BOZEMAN MT 59715

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/13/2023
3. Issuer Name and Ticker or Trading Symbol
FAIR ISAAC CORP [ FICO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Interim Chief Financial Ofc.
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 1,990.0933 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Non Qualified Stock Option (right to buy) 12/10/2019(1) 12/09/2025 Common Stock 1,327 $185.1 D
Restricted Stock Units 07/22/2020(2) (3) Common Stock 365 (4) D
Restricted Stock Units 12/10/2020(2) (3) Common Stock 219 (4) D
Restricted Stock Units 12/10/2022(2) (3) Common Stock 328 (4) D
Restricted Stock Units 12/10/2022(2) (3) Common Stock 602 (4) D
Restricted Stock Units 12/09/2023(2) (3) Common Stock 599 (4) D
Restricted Stock Units 12/09/2025(5) (3) Common Stock 935 (4) D
Restricted Stock Units 01/09/2024(2) (3) Common Stock 1,684 (4) D
Explanation of Responses:
1. This option vests in four equal annual installments commencing on this date.
2. The restricted stock units vest in four equal annual installments commencing on this date and vested shares will be delivered to the reporting person as soon as practicable thereafter.
3. No expiration date.
4. Each restricted stock unit represents a right to receive one share of Fair Isaac common stock contingent upon continued employment.
5. The restricted stock units vest in one annual installment on this date and vested shares will be delivered to the reporting person as soon as practicable thereafter.
Remarks:
Exhibit List - Exhibit 24 - Power of Attorney for Steven P. Weber
/s/ Carrie H. Darling, Attorney-in-fact 01/17/2023
** 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 5 (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 Number.