Sec Form 3 Filing - van de Loo Kaj @ UserTesting, Inc. - 2021-11-16

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
van de Loo Kaj
2. Issuer Name and Ticker or Trading Symbol
UserTesting, Inc. [ USER]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Technology Officer
(Last) (First) (Middle)
144 TOWNSEND STREET
3. Date of Earliest Transaction (MM/DD/YY)
11/16/2021
(Street)
SAN FRANCISCO, CA94107
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
Common Stock 256,078 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) $ 1.02 ( 1 ) 04/23/2029 Common Stock 493,922 D
S tock Option (Right to Buy) $ 0.95 ( 2 ) 06/03/2030 Common Stock 400,000 D
Restricted Stock Unit (RSU) ( 4 ) ( 3 ) 09/21/2031 Common Stock 150,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
van de Loo Kaj
144 TOWNSEND STREET
SAN FRANCISCO, CA94107
Chief Technology Officer
Signatures
/s/ Ambyr O'Donnell as attorney-in-fact for Kaj van de Loo 11/16/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The option vests as to 1/48th of the total shares monthly, beginning May 22, 2019, subject to the Reporting Holder's continued service to theIssuer on each vesting date.
( 2 )The option vests as to 1/48th of the total shares monthly, beginning May 1, 2020, subject to the Reporting Holder's continued service to theIssuer on each vesting date.
( 3 )The Restricted Stock Units ("RSUs") were granted with both (a) a liquidity event-based vesting condition and (b) a service-based vestingcondition, both of which must be satisfied in order for the RSUs to vest. The liquidity event-based vesting condition was satisfied on November16, 2021, the effective date of the issuer's initial public offering. The service-based vesting event will be satisfied as to 25% of the total shares onNovember 15, 2022, with an additional 6.25% of the total shares vesting on each subsequent February 15, May 15, August 15, and November15 thereafter until such time as the RSUs are 100% vested, subject to the Reporting Person's continued service to the Issuer on each vesting date.
( 4 )Each RSU represents a contingent right to receive one (1) share of the Issuer's Common Stock upon settlement for no consideration.

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).

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