Rollin L. Ford - Jun 7, 2022 Form 4 Insider Report for Symbotic Inc. (SYM)

Role
Director
Signature
/s/ Corey Dufresne, Attorney-in-Fact
Stock symbol
SYM
Transactions as of
Jun 7, 2022
Transactions value $
$300,000
Form type
4
Date filed
6/9/2022, 07:59 PM
Next filing
Jul 21, 2022

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction SYM Class A Common Stock Award $300K +30K $10.00* 30K Jun 7, 2022 By Spouse F1, F2
transaction SYM Class V-1 Common Stock Award +1.18M 1.18M Jun 7, 2022 By Spouse F3, F4, F5

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 SYM Symbotic Holdings Units Award +1.18M 1.18M Jun 7, 2022 Class A Common Stock 1.18M By Spouse F3, F4, F5
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Acquired pursuant to a Subscription Agreement, dated December 12, 2021, between the Issuer and RLF 2020 Gift Trust.
F2 Rollin Ford may be considered to have an indirect pecuniary interest in 30,000 shares of Class A Common Stock held directly by the RLF 2020 Gift Trust, in which Mr. Ford's wife acts as trustee and to which Mr. Ford's immediate family have a pecuniary interest. Rollin Ford does not have voting or investment control over the shares and disclaims beneficial ownership of the shares held by the RLF 2020 Gift Trust except to the extent that Mr. Ford may be considered to have an indirect pecuniary interest therein. This report shall not be deemed an admission that the Reporting Person is the beneficial owner of the shares held by the RLF 2020 Gift Trust for purposes of Section 16 or for any other purpose.
F3 Represents Symbotic Holdings Units received as consideration for limited liability company units of Warehouse Technologies LLC ("Warehouse") in connection with the Agreement and Plan of Merger, dated December 12, 2021, by and among the Issuer, Saturn Acquisition (DE) Corp., Warehouse and Symbotic Holdings LLC ("Symbotic Holdings"), as described in the Issuer's final prospectus filed with the Securities and Exchange Commission on June 1, 2022.
F4 The term "Symbotic Holdings Units" is used herein to represent limited liability company units of Symbotic Holdings and an equal number of paired shares of Class V-1 Common Stock of the Issuer, which, pursuant to the limited liability company agreement of Symbotic Holdings, are together redeemable by the holder on a one-for-one basis for a share of Class A Common Stock of the Issuer, subject to conversion rate adjustments for stock splits, stock dividends, reclassification and other similar transactions. Upon redemption, the Issuer will cancel the Symbotic Holdings Units and cancel and retire for no consideration the redeemed shares of Class V-1 Common Stock. Shares of Class V-1 Common Stock of the Issuer have no economic rights and each share of Class V-1 Common Stock entitles its holder to 1 vote per share.
F5 Rollin Ford may be considered to have an indirect pecuniary interest in 393,800 Symbotic Holdings Units held by the Audrey Exempt Trust, u/a, 393,800 Symbotic Holdings Units held by the Jessica Exempt Trust, u/a, and 393,800 Symbotic Holdings Units held by the Paige Exempt Trust, u/a (collectively the "Trust Shares"), each of which has Mr. Ford's spouse as a Trustee and to which members of Mr. Ford's immediate family have a pecuniary interest. Rollin Ford does not have voting or investment control over the Trust Shares and disclaims beneficial ownership of the Trust Shares except to the extent that Mr. Ford may be considered to have an indirect pecuniary interest therein. This report shall not be deemed an admission that the Reporting Person is the beneficial owner of the Trust Shares for purposes of Section 16 or for any other purpose.