0001628280-22-017371 Sample Contracts

RESTRICTED STOCK UNIT AWARD AGREEMENT FOR U.S. EMPLOYEES
Restricted Stock Unit Award Agreement • June 16th, 2022 • Smith Ryan S • Services-prepackaged software

Pursuant to the 2021 Qualtrics International Inc. Employee Omnibus Equity Plan as amended through the date hereof (the “Plan”), Qualtrics International Inc. (the “Company”) hereby grants an award of the number of Restricted Stock Units listed above (an “Award”) to the individual named above (the “Grantee”). Each Restricted Stock Unit shall relate to one share of Class A common stock, par value $0.0001 per share (the “Stock”) of the Company.

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