Sec Form 3 Filing - Witteveen Merel @ C3.ai, Inc. - 2024-06-19

Insider filing report for Changes in Beneficial Ownership
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FORM 3
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Witteveen Merel
2. Issuer Name and Ticker or Trading Symbol
C3.ai, Inc. [ AI]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Interim COO
(Last) (First) (Middle)
C/O C3.AI, INC., 1400 SEAPORT BLVD
3. Date of Earliest Transaction (MM/DD/YY)
06/19/2024
(Street)
REDWOOD CITY, CA94063
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Class A Common Stock 1,229 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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
Stock Option (Right to Buy) $ 4.56 ( 1 ) 06/12/2029 Class A Common Stock 108 D
Stock Option (Right to Buy) $ 4.56 ( 2 ) 07/31/2030 Class A Common Stock 6,247 D
Stock Option (Right to Buy) $ 34.25 ( 3 ) 12/22/2031 Class A Common Stock 36,667 D
Resticted Stock Units ( 5 ) ( 4 ) ( 4 ) Class A Common Stock 13,500 D
Restricted Stock Units ( 5 ) ( 6 ) ( 6 ) Class A Common Stock 25,000 D
Restricted Stock Units ( 5 ) ( 7 ) ( 7 ) Class A Common Stock 130,000 D
Restricted Stock Units ( 5 ) ( 8 ) ( 8 ) Class A Common Stock 30,000 D
Restricted Stock Units ( 5 ) ( 9 ) ( 9 ) Class A Common Stock 50,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Witteveen Merel
C/O C3.AI, INC.
1400 SEAPORT BLVD
REDWOOD CITY, CA94063
Interim COO
Signatures
/s/ Eric Jensen, Attorney-in-Fact 06/28/2024
Signature of Reporting Person Date
Explanation of Responses:
( 1 )20% of the shares subject to the option grant vested on May 1, 2020, and the remaining 80% of the shares vest on a monthly basis for the following four years, so long as the Reporting Person continues to provide services through such vesting dates. The original grant was for 1,667 of which 1,559 shares have been exercised.
( 2 )20% of the shares subject to the option grant vested on May 1, 2021, and the remaining 80% of the shares vest on a monthly basis for the following four years, so long as the Reporting Person continues to provide services through such vesting dates. The original grant was for 25,001 of which 18,754 shares have been exercised.
( 3 )20% of the shares subject to the option grant vested on December 15, 2022, and the remaining 80% of the shares vest on a monthly basis for the following four years, so long as the Reporting Person continues to provide services through such vesting dates. The original grant was for 50,000 of which 13,333 shares have been exercised.
( 4 )20% of such restricted stock award ("RSU") award vested on June 23, 2022 and 5% of such RSU award vest on a quarterly basis thereafter, so long as the Reporting Person continues to provide services through such vesting date. The original grant was for 30,000 of which 16,500 shares have vested and been released.
( 5 )Each RSU represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement.
( 6 )6.25% of such RSU award vested on the third month following July 6, 2022 and 6.25% of each RSU award vest on a quarterly basis thereafter, so long as the Reporting Person continues to provide services through such vesting date. The original grant was for 50,000 of which 25,000 shares have vested and been released.
( 7 )20% of such RSU award vested August 16, 2023 and 5% of such RSU award vest on a quarterly basis thereafter, so long as the Reporting Person continues to provide services through such vesting date. The original grant was for 200,000 of which 70,000 shares have vested and been released.
( 8 )6.25% of such RSU award vest in a series of equal quarterly installments on the last day of each fiscal quarter following May 1, 2025, so long as the Reporting Person continues to provide services through such vesting date.
( 9 )20% of such RSU award vest on June 15, 2025 and 5% of such RSU award vest on a quarterly basis thereafter, so long as the Reporting Person continues to provide services through such vesting date.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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