0001209191-23-054262.txt : 20231102 0001209191-23-054262.hdr.sgml : 20231102 20231102212059 ACCESSION NUMBER: 0001209191-23-054262 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231101 FILED AS OF DATE: 20231102 DATE AS OF CHANGE: 20231102 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: 231374285 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 X0508 4 2023-11-01 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 2023-11-01 4 M 0 53125 A 1809515 D Class A Common Stock 2023-11-01 4 F 0 26340 23.97 D 1783175 D Class A Common Stock 2023-11-02 4 G 0 26785 0.00 D 1756390 D Class A Common Stock 2023-11-02 4 G 0 26785 0.00 A 3675922 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 Restricted Stock Units 2023-11-01 4 M 0 53125 0.00 D Class A Common Stock 53125 531250 D Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement. 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. 6.25% of each such RSU award vested on August 1, 2022 and 6.25% of each such RSU award shall vest on a quarterly basis thereafter, so long as the Reporting Person continues to provide services through such vesting date. /s/ Eric Jensen, Attorney-in-Fact 2023-11-02