0001415889-24-007368.txt : 20240308 0001415889-24-007368.hdr.sgml : 20240308 20240308165249 ACCESSION NUMBER: 0001415889-24-007368 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240306 FILED AS OF DATE: 20240308 DATE AS OF CHANGE: 20240308 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bicket John CENTRAL INDEX KEY: 0001895106 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41140 FILM NUMBER: 24735227 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] ORGANIZATION NAME: 06 Technology IRS NUMBER: 473100039 STATE OF INCORPORATION: DE FISCAL YEAR END: 0203 BUSINESS ADDRESS: STREET 1: 1 DE HARO STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94107 BUSINESS PHONE: (415) 985-2400 MAIL ADDRESS: STREET 1: 1 DE HARO STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94107 FORMER COMPANY: FORMER CONFORMED NAME: Samsara Networks Inc. DATE OF NAME CHANGE: 20150520 4 1 form4-03082024_090342.xml X0508 4 2024-03-06 0001642896 Samsara Inc. IOT 0001895106 Bicket John C/O SAMSARA INC. 1 DE HARO STREET SAN FRANCISCO CA 94107 true true true false SEE REMARKS 0 Class A Common Stock 2024-03-06 4 A 0 162721 0 A 436456 D Class A Common Stock 364172 I See footnote Class A Common Stock 19200 I See footnote Class A Common Stock 76800 I See footnote These securities are restricted stock units (RSUs). Each RSU represents a contingent right to receive one share of Class A Common Stock. One-sixteenth of the RSUs shall vest on June 10, 2024 and each quarterly vesting date thereafter, subject to the Reporting Person continuing as a service provider through each such date. These securities are RSUs. Each RSU represents a contingent right to receive one share of Class A Common Stock, subject to the applicable vesting schedule and conditions of each RSU. Consists of shares held by John C. Bicket, Trustee of the John C. Bicket Revocable Trust u/a/d 2/15/2013, over which the Reporting Person has voting or investment power. 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 the Reporting Person has voting or investment power. 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 the Reporting Person has voting or investment power. Executive Vice President, Chief Technology Officer /s/ Adam Eltoukhy, attorney-in-fact on behalf of John Bicket 2024-03-08