0001837240-24-000065.txt : 20240306 0001837240-24-000065.hdr.sgml : 20240306 20240306062804 ACCESSION NUMBER: 0001837240-24-000065 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240301 FILED AS OF DATE: 20240306 DATE AS OF CHANGE: 20240306 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ford Rollin L. CENTRAL INDEX KEY: 0001429247 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40175 FILM NUMBER: 24724312 MAIL ADDRESS: STREET 1: 702 S.W. 8TH STREET STREET 2: MAIL STOP # 0215 CITY: BENTONVILLE STATE: AR ZIP: 72716-0215 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Symbotic Inc. CENTRAL INDEX KEY: 0001837240 STANDARD INDUSTRIAL CLASSIFICATION: GENERAL INDUSTRIAL MACHINERY & EQUIPMENT, NEC [3569] ORGANIZATION NAME: 06 Technology IRS NUMBER: 981572401 STATE OF INCORPORATION: DE FISCAL YEAR END: 0928 BUSINESS ADDRESS: STREET 1: 200 RESEARCH DRIVE CITY: WILMINGTON STATE: MA ZIP: 01887 BUSINESS PHONE: 978-284-2800 MAIL ADDRESS: STREET 1: 200 RESEARCH DRIVE CITY: WILMINGTON STATE: MA ZIP: 01887 FORMER COMPANY: FORMER CONFORMED NAME: SVF Investment Corp. 3 DATE OF NAME CHANGE: 20210128 FORMER COMPANY: FORMER CONFORMED NAME: SVF Investment III Corp. DATE OF NAME CHANGE: 20201218 4 1 wk-form4_1709724477.xml FORM 4 X0508 4 2024-03-01 0 0001837240 Symbotic Inc. SYM 0001429247 Ford Rollin L. C/O SYMBOTIC INC., 200 RESEARCH DRIVE WILMINGTON MA 01887 1 0 0 0 0 Class A Common Stock 2024-03-01 4 M 0 10447 A 10447 D Class A Common Stock 8000 I By Rollin L Ford Trust Class A Common Stock 30000 I By Spouse Restricted Stock Units 2024-03-01 4 M 0 10447 0 D Class A Common Stock 10447 0 D Restricted Stock Units 2024-03-01 4 A 0 4060 0 A Class A Common Stock 4060 4060 D Restricted stock units convert into Class A common stock on a one-for-one basis. 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. Each restricted stock unit represents a contingent right to receive one share of the Issuer's Class A common stock. On March 1, 2023, the Reporting Person was granted 10,447 restricted stock units that vest in full upon the earliest of: (1) March 1, 2024, (2) the Issuer's 2024 Annual Meeting of Stockholders or (3) a change of control of the Issuer, subject to the Reporting Person's continued service with the Issuer on the vesting date. The restricted stock units vest in full upon the earliest of: (1) March 1, 2025, (2) the Issuer's 2025 Annual Meeting of Stockholders or (3) a change of control of the Issuer, subject to the Reporting Person's continued service with the Issuer on the vesting date. /s/ Corey Dufresne. Attorney-in-Fact 2024-03-05