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Jeffrey Scott Jacobs

Filed: 7 Sep 21, 4:08pm
SEC Form 4
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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OMB Number: 3235-0287
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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*
Jacobs Jeffrey Scott

(Last) (First) (Middle)
C/O CERIDIAN HCM HOLDING INC.
3311 E. OLD SHAKOPEE ROAD

(Street)
MINNEAPOLIS MN 55425

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Ceridian HCM Holding Inc. [ CDAY ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Head of Acct & Fin Reporting
3. Date of Earliest Transaction (Month/Day/Year)
09/03/2021
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 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 09/03/2021 M 1,000(1) A $16.82 5,840 D
Common Stock 09/03/2021 S 1,000(1) D $115 4,840(2) 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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option (right to buy) $17.58 (3) 12/08/2025 Common Stock 500 500 D
Option (right to buy) $16.82 09/03/2021 M 1,000(1) (3) 12/31/2026 Common Stock 1,000 (4) 1,125 D
Option (right to buy) $19.04 (5) 12/20/2027 Common Stock 5,000 5,000 D
Option (right to buy) $22 (6) 04/25/2028 Common Stock 32,610 32,610 D
Option (right to buy) $44.91 (7) 02/08/2029 Common Stock 712 712 D
Option (right to buy) $49.93 (8) 03/20/2029 Common Stock 8,396 8,396 D
Option (right to buy) $65.26 (9) 05/08/2030 Common Stock 14,299 14,299 D
Performance Units (10) (10) 03/08/2022 Common Stock 593 593 D
Performance Units (11) (11) 03/08/2024 Common Stock 2,470 2,470 D
Explanation of Responses:
1. The sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan.
2. Includes (i) 1,200 shares of common stock, (ii) shares issuable pursuant to Restricted Stock Units (RSUs), granted on February 28, 2020, of which 74 shares vest on each of February 28, 2022 and February 28, 2023, (iii) shares issuable pursuant to RSUs, granted on May 8, 2020, of which 511 shares vest on each of May 8, 2022 and May 8, 2023; and (iv) shares that are issuable pursuant to RSUs, granted on March 8, 2021, of which 823 shares vest on each of March 8, 2022 and March 8, 2023 and 824 shares that vest on March 8, 2024.
3. Fully vested and exercisable.
4. Not Applicable
5. Consists of 3,750 vested and exercisable options and 1,250 options that vest and become exercisable on December 20, 2021.
6. Consists of 24,457 vested and exercisable options and 8,153 options that vest and become exercisable on April 25, 2022.
7. Consists of 356 vested and exercisable options and 178 options that vest and become exercisable on each of February 8, 2022 and February 8, 2023.
8. Consists of 4,198 vested and exercisable options and 2,099 options that vest and become exercisable on each of March 20, 2022 and March 20, 2023.
9. Consists of 3,574 vested and exercisable options and 3,575 options that vest and become exercisable on each of May 8, 2022, May 8, 2023, and May 8, 2024.
10. Each performance stock unit represents a contingent right to receive between .25 and 1.50 shares of Common Stock based upon the degree to which one or both of the Cloud Revenue and Adjusted EBITDA Margin performance metrics under the Companys 2021 Management Incentive Plan are satisfied. The performance stock units vest upon the later of (i) the date the Compensation Committee or the Board certify that one or both of the performance metrics have been met and (ii) March 8, 2022.
11. Each performance stock unit represents a contingent right to receive between .25 and 1.50 shares of Common Stock based upon the degree to which one or both of the Cloud Revenue and Adjusted EBITDA Margin performance metrics contained in the performance stock unit award agreement are satisfied. The performance stock units will only vest if the achievement of one or both of the performance metrics is certified by the Compensation Committee or the Board of Directors of the Company to have been met, and then any such certified amount will vest one-third on each anniversary of the date of grant.
Remarks:
For Jeffrey Jacobs pursuant to the Power of Attorney previously filed.
/s/ William E. McDonald 09/07/2021
** 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).
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