John Bicket - 14 Dec 2021 Form 3 Insider Report for Samsara Inc. (IOT)

Reporting relationship: Executive Vice President, Chief Technology Officer Power of Attorney, Director, 10%+ Owner
Issuer ticker: IOT
Reported as of: 14 Dec 2021
Net transaction value: $0
SEC form: 3
Accepted by SEC: 14 Dec 2021, 20:28:54 UTC
Next SEC filing: 21 Dec 2021
Source filing: View source filing
Reporting owner signature: /s/ Adam Eltoukhy, attorney-in-fact on behalf of John Bicket

Key filing fact

John Bicket filed Form 3 for Samsara Inc. (IOT) on 14 Dec 2021.

Key facts

This page summarizes John Bicket's Form 3 filing for Samsara Inc. (IOT).
0 reported transactions and 14 derivative rows are listed below.
Accepted by SEC: 14 Dec 2021, 20:28.

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: 1,286,597
Exercise price
Footnotes: F1

IOT holding Derivative

Stock Option (right to buy)

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: 570,031
Exercise price: $3.51
Footnotes: 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: 66,533,236
Exercise price
Footnotes: F1, F4

IOT holding Derivative

Series A Preferred Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: See footnote
Underlying class: Class B Common Stock
Underlying amount: 12,386,955
Exercise price
Footnotes: F3, F4

IOT holding Derivative

Series B Preferred Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: See footnote
Underlying class: Class B Common Stock
Underlying amount: 4,629,639
Exercise price
Footnotes: F3, F4

IOT holding Derivative

Series C Preferred Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after
Date: 14 Dec 2021
Ownership: See footnote
Underlying class: Class B Common Stock
Underlying amount: 1,351,441
Exercise price
Footnotes: F3, 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: 2,292,432
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: 15,591,942
Exercise price
Footnotes: F1, F6

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: 2,292,432
Exercise price
Footnotes: F1, F7

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: 1,286,597
Exercise price
Footnotes: F1, F8

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: 4,466,764
Exercise price
Footnotes: F1, F9

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: 250,000
Exercise price
Footnotes: F1, F10

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: 250,000
Exercise price
Footnotes: F1, F11

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: 250,000
Exercise price
Footnotes: F1, F12

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

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 12 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

1/48 of the total shares subject to the Option vested on March 4, 2019 and thereafter 1/48 of the shares subject to the Option vest each month thereafter on the same day of the month.

Footnote F3

The Series A, Series B and Series C Preferred Stock are each convertible into Class B Common Stock on a 1:1 basis and have no expiration date. Upon the closing of the Issuer's initial public offering, all shares of Series A, Series B and Series C 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 F4

Consists of shares held by John C. Bicket, Trustee of the John C. Bicket Revocable Trust u/a/d 2/15/2013, over which Mr. Bicket has voting or investment power.

Footnote F5

Consists of shares held by CBD, Trustee of The CBD 2020 Annuity Trust u/a/d 12/23/2020, over which Mr. Bicket has voting or investment power.

Footnote F6

Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Bicket-Dobson Trust II u/a/d 10/8/2021, over which Mr. Bicket has voting or investment power.

Footnote F7

Consists of shares held by John C. Bicket, Trustee of The John C. Bicket 2020 Annuity Trust u/a/d 12/23/2020, over which Mr. Bicket has voting or investment power.

Footnote F8

Consists of shares held by Mr. Bicket's spouse.

Footnote F9

Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Bicket-Dobson Trust I u/a/d 11/10//2021, over which Mr. Bicket has voting or investment power.

Footnote F10

Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Bicket-Dobson Trust I-A fbo ACDB u/a/d 11/10/2021, over which Mr. Bicket has voting or investment power.

Footnote F11

Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Bicket-Dobson Trust I-A fbo JCDB u/a/d 11/10/2021, over which Mr. Bicket has voting or investment power.

Footnote F12

Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Bicket-Dobson Trust I-A u/a/d 11/10/2021, over which Mr. Bicket has voting or investment power.

SEC remarks

Executive Vice President, Chief Technology Officer Power of Attorney

We use cookies and similar technologies to provide certain features, enhance the user experience and, if you allow them, measure engagement and deliver advertising. Analytics and marketing storage stay off until you grant consent. By clicking on "Agree and continue", you declare your consent to the use of the selected optional cookies. to update or revoke optional consent for future visits. For more information, see our Privacy Policy .