SEC FORM 5 SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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).
Form 3 Holdings Reported.
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
Crockett Todd

(Last) (First) (Middle)
C/O ZOOMINFO TECHNOLOGIES, INC
805 BROADWAY STREET, SUITE 900

(Street)
VANCOUVER WA 98660

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ZoomInfo Technologies Inc. [ ZI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Class A Common Stock 09/01/2021 G 0(1) D $0.00 24,595,353 I See Footnotes(2)(3)
Class A Common Stock 09/01/2021 G 0(1) D $0.00 1,608,404 I See Footnotes(3)(4)
Class A Common Stock 09/01/2021 G 0(1) D $0.00 6,433,622 I See Footnotes(3)(5)
Class A Common Stock 4,247,593 I See Footnotes(3)(6)
Class A Common Stock 1,443,013 I See Footnotes(3)(7)
Class A Common Stock 5,772,061 I See Footnotes(3)(8)
Class A Common Stock 913,459 I See Footnotes(3)(9)
Class A Common Stock 634,937 I See Footnotes(3)(10)
Class A Common Stock 30,327 I See Footnotes(3)(11)
Class A Common Stock 121,318 I See Footnotes(3)(12)
Class A Common Stock 108,479 I By Trust
Class A Common Stock 564 I By Trust
Class A Common Stock 564 I By Trust
Class A Common Stock 1,154 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 (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)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Represents a gift of Mr. Crockett's interest in TA Associates XI GP, L.P., the direct general partner of TA XI DO AIV, L.P., TA XI DO AIV II, L.P and TA XI DO Feeder, L.P. (collectively, the "TA XI funds"). Each transaction represents a gift of 2.9217% of Mr. Crockett's interest in TA Associates XI GP, L.P., which has a corresponding pro rata effect on Mr. Crockett's interest in the TA XI funds.
2. Securities are held by TA XI DO AIV, L.P.
3. TA Associates, L.P. is the ultimate general partner of each of XI DO, SDF III Feeder, Atlantic & Pacific VII-B, XI DO AIV, SDF III DO, Atlantic & Pacific VII-A, Investors IV, AP VII-B, SDF III DO AIV II and XI DO AIV II (collectively, the "TA Associates Funds"). Investment and voting control of the TA Associates Funds is held by TA Associates, L.P. The Reporting Person disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest in such securities, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for Section 16 or any other purpose.
4. Securities are held by TA XI DO AIV II, L.P.
5. Securities are held by TA XI DO Feeder, L.P.
6. Securities are held by TA Atlantic and Pacific VII-A, L.P.
7. Securities are held by TA AP VII-B DO Subsidiary Partnership, L.P.
8. Securities are held by TA Atlantic and Pacific VII-B, L.P.
9. Securities are held by TA Investors IV, L.P.
10. Securities are held by TA SDF III DO AIV, L.P.
11. Securities are held by TA SDF III DO AIV II, L.P.
12. Securities are held by TA SDF III DO Feeder, L.P.
Remarks:
/s/ Todd Crockett 02/14/2022
** 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).
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