Benjamin Calderon - 14 Dec 2021 Form 3 Insider Report for Samsara Inc. (IOT)

Reporting relationship: Executive Vice President, Chief Technology Officer, Hardware and Operations Power of Attorney
Issuer ticker: IOT
Reported as of: 14 Dec 2021
Net transaction value: $0
SEC form: 3
Accepted by SEC: 14 Dec 2021, 20:11:20 UTC
Next SEC filing: 21 Dec 2021
Source filing: View source filing
Reporting owner signature: /s/ Adam Eltoukhy, attorney-in-fact on behalf of Benjamin Calderon

Key filing fact

Benjamin Calderon filed Form 3 for Samsara Inc. (IOT) on 14 Dec 2021.

Key facts

This page summarizes Benjamin Calderon's Form 3 filing for Samsara Inc. (IOT).
0 reported transactions and 6 derivative rows are listed below.
Accepted by SEC: 14 Dec 2021, 20:11.

Change

No earlier filing in this sequence is available for direct comparison.
Current net transaction value: $0.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Official SEC source

Ownership activity is grounded in SEC Form 3 disclosures.

View source filing

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

IOT holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: Direct
Underlying class: Class A Common Stock
Underlying amount: 9,427,242
Exercise price
Footnotes: F1

IOT holding Derivative

Series A Preferred Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: Direct
Underlying class: Class B Common Stock
Underlying amount: 271,761
Exercise price
Footnotes: F1, F2

IOT holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: See footnote
Underlying class: Class A Common Stock
Underlying amount: 908,700
Exercise price
Footnotes: F1, F3

IOT holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: See footnote
Underlying class: Class A Common Stock
Underlying amount: 908,700
Exercise price
Footnotes: F1, F4

IOT holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: See footnote
Underlying class: Class A Common Stock
Underlying amount: 908,700
Exercise price
Footnotes: F1, F5

IOT holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: See footnote
Underlying class: Class A Common Stock
Underlying amount: 290,000
Exercise price
Footnotes: F1, F6

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 6 footnotes

Footnote F1

The Class B Common Stock is convertible at any time, at the holder's election, into Class A Common Stock on a 1:1 basis and has no expiration date.

Footnote F2

The Series A Preferred Stock is convertible into Class B Common Stock on a 1:1 basis and has no expiration date. Upon the closing of the Issuer's initial public offering, all shares of Series A Preferred Stock will be converted into shares of Class B Common Stock of the Issuer. The Class B Common Stock is convertible at any time, at the holder's election, into Class A Common Stock on a 1:1 basis.

Footnote F3

Consists of shares held by Fall MC, LLC, over which Mr. Calderon has voting or investment power.

Footnote F4

Consists of shares held by Summer NC, LLC, over which Mr. Calderon has voting or investment power.

Footnote F5

Consists of shares held by Winter EC, LLC, over which Mr. Calderon has voting or investment power.

Footnote F6

Consists of shares held by CH 2021 GRAT, over which Mr. Calderon has voting or investment power.

SEC remarks

Executive Vice President, Chief Technology Officer, Hardware and Operations Power of Attorney

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