Benjamin Calderon - 17 Dec 2021 Form 4 Insider Report for Samsara Inc. (IOT)

Role
Executive Vice President, Chief Technology Officer, Hardware and Operations
Signature
/s/ Adam Eltoukhy, attorney-in-fact on behalf of Benjamin Calderon
Issuer symbol
IOT
Transactions as of
17 Dec 2021
Net transactions value
$0
Form type
4
Filing time
21 Dec 2021, 20:53:09 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 -271,761 -100% $0.000000* 0 17 Dec 2021 Class B Common Stock 271,761 $0.000000 Direct F1
transaction IOT Class B Common Stock Conversion of derivative security $0 +271,761 +2.9% $0.000000 9,699,003 17 Dec 2021 Class A Common Stock 271,761 $0.000000 Direct F1
holding IOT Class B Common Stock 908,700 17 Dec 2021 Class A Common Stock 908,700 $0.000000 See footnote F2, F6
holding IOT Class B Common Stock 908,700 17 Dec 2021 Class A Common Stock 908,700 $0.000000 See footnote F3, F6
holding IOT Class B Common Stock 908,700 17 Dec 2021 Class A Common Stock 908,700 $0.000000 See footnote F4, F6
holding IOT Class B Common Stock 290,000 17 Dec 2021 Class A Common Stock 290,000 $0.000000 See footnote F5, F6
* 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 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 Fall MC, LLC, over which Mr. Calderon has voting or investment power.
F3 Consists of shares held by Summer NC, LLC, over which Mr. Calderon has voting or investment power.
F4 Consists of shares held by Winter EC, LLC, over which Mr. Calderon has voting or investment power.
F5 Consists of shares held by CH 2021 GRAT, over which Mr. Calderon has voting or investment power.
F6 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, Hardware and Operations