| FORM 4 | 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 or Section 30(h) of the Investment Company Act of 1940 |
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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). | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol CCC Intelligent Solutions Holdings Inc. [ CCCS ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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| 3. Date of Earliest Transaction (Month/Day/Year) 10/21/2021 | ||||||||||||||||||||||||||
| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 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 | ||||||
| Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 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 (Month/Day/Year) | 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: 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 | ||||||||
| Restricted Stock Unit(1) | $0 | 10/21/2021 | A | 2,400,000 | (1) | (1) | Common Stock | 2,400,000 | $0 | 2,400,000 | D | ||||
| Performance Restricted Stock Unit(2) | $0 | 10/21/2021 | A | 4,800,000 | (2) | (2) | Common Stock | 4,800,000(2) | $0 | 4,800,000 | D | ||||
| Explanation of Responses: |
| 1. The Reporting Person was granted Restricted Stock Units ("RSUs") which represent a contingent right to receive, at the Issuer's discretion, (i) one share of Common Stock for each RSU, (ii) an amount of cash equal to the fair market value of such share of Common Stock on the date immediately preceding the date of settlement of the RSU, or (iii) a combination thereof. Twenty-five (25%) of the RSUs vest upon each of the first four anniversaries of July 30, 2021, generally subject to the Reporting Person's continued service to the Issuer through each such vesting and settlement date. |
| 2. The Reporting Person was granted Performance Restricted Stock Units ("PSUs") which represent a contingent right to receive, at the Issuer's discretion, (i) a distribution of a number of shares of the Issuer's Common Stock equal to 0% to 150% (or such greater percentage as is determined by the Board of Directors of the Issuer) of the PSUs, (ii) an amount of cash equal to the fair market value of such number of shares of the Issuer's Common Stock on the date immediately preceding the date of settlement of the PSUs, or (iii) a combination thereof, in all cases based on the total shareholder return realized by the Issuer's stockholders over the period August 2, 2021 through December 31, 2023 and generally subject to the Reporting Person's continued service to the Issuer through the Issuer's certification of the performance results. |
| Remarks: |
| Chief Executive Officer and Chairman |
| /s/ Kevin Kane as Attorney-in-Fact for Githesh Ramamurthy | 10/25/2021 | |
| ** 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 Number. | ||
