0001209191-22-019903.txt : 20220317 0001209191-22-019903.hdr.sgml : 20220317 20220317210618 ACCESSION NUMBER: 0001209191-22-019903 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220315 FILED AS OF DATE: 20220317 DATE AS OF CHANGE: 20220317 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McCall Andy CENTRAL INDEX KEY: 0001895104 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41140 FILM NUMBER: 22750842 MAIL ADDRESS: STREET 1: 350 RHODE ISLAND STREET STREET 2: 4TH FLOOR, SOUTH BUILDING CITY: SAN FRANCISCO STATE: CA ZIP: 94103 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Samsara Inc. CENTRAL INDEX KEY: 0001642896 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 473100039 STATE OF INCORPORATION: DE FISCAL YEAR END: 0201 BUSINESS ADDRESS: STREET 1: 350 RHODE ISLAND STREET STREET 2: 4TH FLOOR, SOUTH BUILDING CITY: SAN FRANCISCO STATE: CA ZIP: 94103 BUSINESS PHONE: (415) 985-2400 MAIL ADDRESS: STREET 1: 350 RHODE ISLAND STREET STREET 2: 4TH FLOOR, SOUTH BUILDING CITY: SAN FRANCISCO STATE: CA ZIP: 94103 FORMER COMPANY: FORMER CONFORMED NAME: Samsara Networks Inc. DATE OF NAME CHANGE: 20150520 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-03-15 0 0001642896 Samsara Inc. IOT 0001895104 McCall Andy C/O SAMSARA INC., 350 RHODE ISLAND ST. 4TH FLOOR, SOUTH BUILDING SAN FRANCISCO CA 94103 0 1 0 0 See remarks Class A Common Stock 2022-03-15 4 C 0 106250 0.00 A 106250 D Class A Common Stock 2022-03-15 4 A 0 279163 0.00 A 385413 D Class A Common Stock 2022-03-15 4 S 0 29103 13.1552 D 356310 D Class A Common Stock 2022-03-15 4 S 0 15111 13.7721 D 341199 D Class B Common Stock 2022-03-15 4 M 0 602083 0.00 D Class B Common Stock 602083 1097917 D Class B Common Stock 0.00 2022-03-15 4 M 0 602083 0.00 A Class A Common Stock 602083 1841622 D Class B Common Stock 0.00 2022-03-15 4 C 0 106250 0.00 D Class A Common Stock 106250 1735372 D Class B Common Stock 0.00 Class A Common Stock 5399627 5399627 I See footnote Class B Common Stock 0.00 Class A Common Stock 1673333 1673333 I See footnote Class B Common Stock 0.00 Class A Common Stock 646853 646853 I See footnote Class B Common Stock 0.00 Class A Common Stock 646853 646853 I See footnote Includes 279,163 restricted stock units, or RSUs, granted on March 15, 2022 that vest in 16 equal quarterly installments following March 17, 2022. These shares were disposed of in non-discretionary transactions to cover the reporting person's tax withholding obligations in connection with the settlement of an award of RSUs. The "Amount" and "Price" reported in this Column 4 reflect the aggregate number and weighted-average price, respectively, of shares sold. These shares were sold in multiple transactions at prices ranging from $12.58 to $13.57 inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the SEC staff, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth herein. The "Amount" and "Price" reported in this Column 4 reflect the aggregate number and weighted-average price, respectively, of shares sold. These shares were sold in multiple transactions at prices ranging from $13.59 to $14.14 inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the SEC staff, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth herein. The reported shares are represented by RSUs, of which 495,833 vested on December 14, 2021 that were previously reported, 106,250 vested on March 15, 2022 and the remaining shares vest in quarterly installments through December 15, 2024. Each RSU represents a contingent right to receive one share of Issuer Class B 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. Total reflects a previously reported exempt disposition to the Issuer under Rule 16b-3(e) of 110,998 shares of Class B common stock, which the Reporting Person remitted to the Issuer in connection with the satisfaction of tax withholding obligations arising out of the vesting of RSUs. Totals reflect a scheduled distribution of Class B Common Stock to The JAM and BAM Joint Living Trust from The James Andrew McCall III 2020 Annuity Trust and The BAM 2020 Annity Trust on March 2, 2022. Consists of shares held by JAM and BAM, Co-Trustees of The JAM and BAM Joint Living Trust u/a/d 6/30/2009, over which Mr. McCall has voting or investment power. Consists of shares held by JAM and BAM, Co-Trustees of The McCall 2020 Irrevocable Children's Trust u/a/d 8/7/2020, over which Mr. McCall has voting or investment power. Consists of shares held by James Andrew McCall III, Trustee of The James Andrew McCall III 2020 Annuity Trust u/a/d 8/7/2020, over which Mr. McCall has voting or investment power. Consists of shares held by BAM, Trustee of The BAM 2020 Annuity Trust u/a/d 8/7/2020, over which Mr. McCall has voting or investment power. Executive Vice President, Chief Revenue Officer /s/ Adam Eltoukhy, attorney-in-fact on behalf of Andy McCall 2022-03-17