0001209191-23-039222.txt : 20230622 0001209191-23-039222.hdr.sgml : 20230622 20230622211851 ACCESSION NUMBER: 0001209191-23-039222 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230620 FILED AS OF DATE: 20230622 DATE AS OF CHANGE: 20230622 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: 231034756 MAIL ADDRESS: STREET 1: 1400 SEAPORT BLVD 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: 1400 SEAPORT BLVD CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-503-2200 MAIL ADDRESS: STREET 1: 1400 SEAPORT BLVD 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 X0407 4 2023-06-20 0 0001577526 C3.ai, Inc. AI 0001031530 SIEBEL THOMAS M C/O C3.AI, INC. 1400 SEAPORT BLVD REDWOOD CITY CA 94603 1 1 1 0 Chief Executive Officer 0 Class A Common Stock 2023-06-20 4 A 0 23153 0.00 A 1779543 D Class A Common Stock 2023-06-20 4 F 0 11480 43.19 D 1768063 D Class A Common Stock 2023-06-22 4 G 0 11673 0.00 D 1756390 D Class A Common Stock 2023-06-22 4 G 0 11673 0.00 A 3622352 I See Footnote 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 Represents the grant of Restricted Stock Units (RSUs). Each RSU represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement. The RSUs are fully vested. The shares are held by The Siebel Living Trust u/a/d 7/27/93, as amended, of which the Reporting Person is trustee. 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. /s/ Eric Jensen, Attorney-in-Fact 2023-06-22