0001415889-24-007379.txt : 20240308
0001415889-24-007379.hdr.sgml : 20240308
20240308170100
ACCESSION NUMBER: 0001415889-24-007379
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: Phillips Dominic
CENTRAL INDEX KEY: 0001895148
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41140
FILM NUMBER: 24735350
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_100331.xml
X0508
4
2024-03-06
0001642896
Samsara Inc.
IOT
0001895148
Phillips Dominic
C/O SAMSARA INC.
1 DE HARO STREET
SAN FRANCISCO
CA
94107
false
true
false
false
SEE REMARKS
0
Class A Common Stock
2024-03-06
4
A
0
591715
0
A
1264915
D
Class A Common Stock
1061816
I
See footnote
Class A Common Stock
4
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 March 15, 2024 and each quarterly vesting date thereafter, subject to the Reporting Person continuing as a service provider through each such date.
The number of shares held reflects the transfer, of 1,061,816 shares of Class A Common Stock from the Reporting Person to The Phillips Family Trust dated 5/9/201, of which the Reporting Person and his spouse serve as trustees (the "Phillips Family Trust").
Certain of 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 the Phillips Family Trust.
Consists of shares held by the Reporting Person's children.
Executive Vice President, Chief Financial Officer
/s/ Adam Eltoukhy, attorney-in-fact on behalf of Dominic Phillips
2024-03-08