John Bicket - 17 Dec 2021 Form 4 Insider Report for Samsara Inc. (IOT)

Role
Executive Vice President, Chief Technology Officer, Director, 10%+ Owner
Signature
/s/ Adam Eltoukhy, attorney-in-fact on behalf of John Bicket
Issuer symbol
IOT
Transactions as of
17 Dec 2021
Net transactions value
$0
Form type
4
Filing time
21 Dec 2021, 20:48:38 UTC
Previous filing
14 Dec 2021
Next filing
17 Mar 2022
SEC
View on sec.gov

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction IOT Series A Preferred Stock Conversion of derivative security $0 -12,386,955 -100% $0.000000* 0 17 Dec 2021 Class B Common Stock 12,386,955 $0.000000 See footnote F1, F2
transaction IOT Class B Common Stock Conversion of derivative security $0 +12,386,955 +19% $0.000000 78,920,191 17 Dec 2021 Class A Common Stock 12,386,955 $0.000000 See footnote F1, F2
transaction IOT Series B Preferred Stock Conversion of derivative security $0 -4,629,639 -100% $0.000000* 0 17 Dec 2021 Class B Common Stock 4,629,639 $0.000000 See footnote F1, F2
transaction IOT Class B Common Stock Conversion of derivative security $0 +4,629,639 +5.9% $0.000000 83,549,830 17 Dec 2021 Class A Common Stock 4,629,639 $0.000000 See footnote F1, F2
transaction IOT Series C Preferred Stock Conversion of derivative security $0 -1,351,441 -100% $0.000000* 0 17 Dec 2021 Class B Common Stock 1,351,441 $0.000000 See footnote F1, F2
transaction IOT Class B Common Stock Conversion of derivative security $0 +1,351,441 +1.6% $0.000000 84,901,271 17 Dec 2021 Class A Common Stock 1,351,441 $0.000000 See footnote F1, F2
holding IOT Class B Common Stock 1,286,597 17 Dec 2021 Class A Common Stock 1,286,597 $0.000000 Direct F11
holding IOT Class B Common Stock 2,292,432 17 Dec 2021 Class A Common Stock 2,292,432 $0.000000 See footnote F3, F11
holding IOT Class B Common Stock 15,591,942 17 Dec 2021 Class A Common Stock 15,591,942 $0.000000 See footnote F4, F11
holding IOT Class B Common Stock 2,292,432 17 Dec 2021 Class A Common Stock 2,292,432 $0.000000 See footnote F5, F11
holding IOT Class B Common Stock 1,286,597 17 Dec 2021 Class A Common Stock 1,286,597 $0.000000 See footnote F6, F11
holding IOT Class B Common Stock 4,466,764 17 Dec 2021 Class A Common Stock 4,466,764 $0.000000 See footnote F7, F11
holding IOT Class B Common Stock 250,000 17 Dec 2021 Class A Common Stock 250,000 $0.000000 See footnote F8, F11
holding IOT Class B Common Stock 250,000 17 Dec 2021 Class A Common Stock 250,000 $0.000000 See footnote F9, F11
holding IOT Class B Common Stock 250,000 17 Dec 2021 Class A Common Stock 250,000 $0.000000 See footnote F10, F11
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Each share of Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock automatically converted into Class B Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock. 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.
F2 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.
F3 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.
F4 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.
F5 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.
F6 Consists of shares held by Mr. Bicket's spouse.
F7 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.
F8 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.
F9 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.
F10 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.
F11 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.

Remarks:

Executive Vice President, Chief Technology Officer