Statement of Changes in Beneficial Ownership (4)
June 02 2023 - 4:19PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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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
*
Christo Rodney |
2. Issuer Name and Ticker or Trading Symbol
CCC Intelligent Solutions Holdings Inc.
[
CCCS
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Chief Accounting Officer |
(Last)
(First)
(Middle)
C/O CCC INTELLIGENT SOLUTIONS HOLDINGS, 167 N. GREEN STREET, 9TH FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
5/31/2023 |
(Street)
CHICAGO, IL 60607 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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(City)
(State)
(Zip)
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Rule 10b5-1(c) Transaction Indication
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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to
satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | | | | | | | | 130340 (1) | I | By Trust |
Common Stock | 5/31/2023 | | M(2) | | 1005 | A | $2.92 | 1005 (1) | D | |
Common Stock | 5/31/2023 | | S(2) | | 1005 | D | $11.0044 (3) | 0 (1) | D | |
Common Stock | 6/1/2023 | | M(2) | | 11495 | A | $2.92 | 11495 (1) | D | |
Common Stock | 6/1/2023 | | S(2) | | 11495 | D | $11.0772 (3) | 0 (1) | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) | $2.92 | 5/31/2023 | | M (2) | | | 1005 | (4) | 4/11/2029 | Common Stock | 1005 | $0 | 33050 | D | |
Stock Option (Right to Buy) | $2.92 | 6/1/2023 | | M (2) | | | 11495 | (4) | 4/11/2029 | Common Stock | 11495 | $0 | 21555 | D | |
Explanation of Responses: |
(1) | The amount of reported securities gives effect to a transfer of 5,846 shares from the Reporting Person's direct holdings to a revocable trust of which the Reporting Person is the Beneficial Owner, which transfer constituted a non-reportable change in form. |
(2) | The transactions reported on this Form 4 occurred automatically pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person on August 9, 2022. |
(3) | The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $11.0000 to $11.1950. The Reporting Person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range provided. |
(4) | In connection with the acquisition of Cypress Holdings, Inc. by CCC Intelligent Solutions Holdings Inc. (the "Issuer") by merger on July 30, 2021 (the "Merger"), and pursuant to the business combination agreement, the Reporting Person received stock options of the Issuer ("Options") on July 30, 2021 in respect of stock options of Cypress Holdings, Inc. which were subject to performance vesting, provided that all performance vesting conditions were deemed fully satisfied in connection with the Merger and the Options were fully vested upon grant. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Christo Rodney C/O CCC INTELLIGENT SOLUTIONS HOLDINGS 167 N. GREEN STREET, 9TH FLOOR CHICAGO, IL 60607 |
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| Chief Accounting Officer |
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Signatures
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/s/ Kevin Kane as Attorney-in-Fact for Rodney Christo | | 6/2/2023 |
**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 4(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 control number. |
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