Sanjit Biswas - Dec 17, 2021 Form 4 Insider Report for Samsara Inc. (IOT)

Role
Chief Executive Officer, Director, 10%+ Owner
Signature
/s/ Adam Eltoukhy, attorney-in-fact on behalf of Sanjit Biswas
Stock symbol
IOT
Transactions as of
Dec 17, 2021
Transactions value $
$0
Form type
4
Date filed
12/21/2021, 08:49 PM
Previous filing
Dec 16, 2021
Next filing
Mar 17, 2022
SEC
View on sec.gov

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 IOT Series A Preferred Stock Conversion of derivative security $0 -12.4M -100% $0.00* 0 Dec 17, 2021 Class B Common Stock 12.4M $0.00 Direct F1
transaction IOT Class B Common Stock Conversion of derivative security $0 +12.4M +18.6% $0.00 79M Dec 17, 2021 Class A Common Stock 12.4M $0.00 See footnote F1, F2
transaction IOT Series B Preferred Stock Conversion of derivative security $0 -4.63M -100% $0.00* 0 Dec 17, 2021 Class B Common Stock 4.63M $0.00 See footnote F1, F2
transaction IOT Class B Common Stock Conversion of derivative security $0 +4.63M +5.86% $0.00 83.6M Dec 17, 2021 Class A Common Stock 4.63M $0.00 See footnote F1, F2
transaction IOT Series C Preferred Stock Conversion of derivative security $0 -1.35M -100% $0.00* 0 Dec 17, 2021 Class B Common Stock 1.35M $0.00 See footnote F1, F2
transaction IOT Class B Common Stock Conversion of derivative security $0 +1.35M +1.62% $0.00 85M Dec 17, 2021 Class A Common Stock 1.35M $0.00 See footnote F1, F2
holding IOT Class B Common Stock 1.29M Dec 17, 2021 Class A Common Stock 1.29M $0.00 Direct F12
holding IOT Class B Common Stock 4.16M Dec 17, 2021 Class A Common Stock 4.16M $0.00 See footnote F3, F12
holding IOT Class B Common Stock 15.6M Dec 17, 2021 Class A Common Stock 15.6M $0.00 See footnote F4, F12
holding IOT Class B Common Stock 2.29M Dec 17, 2021 Class A Common Stock 2.29M $0.00 See footnote F5, F12
holding IOT Class B Common Stock 2.29M Dec 17, 2021 Class A Common Stock 2.29M $0.00 See footnote F6, F12
holding IOT Class B Common Stock 250K Dec 17, 2021 Class A Common Stock 250K $0.00 See footnote F7, F12
holding IOT Class B Common Stock 250K Dec 17, 2021 Class A Common Stock 250K $0.00 See footnote F8, F12
holding IOT Class B Common Stock 250K Dec 17, 2021 Class A Common Stock 250K $0.00 See footnote F9, F12
holding IOT Class B Common Stock 250K Dec 17, 2021 Class A Common Stock 250K $0.00 See footnote F10, F12
holding IOT Class B Common Stock 1.29M Dec 17, 2021 Class A Common Stock 1.29M $0.00 See footnote F11, F12
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Each share of Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock automatically converted into Class B Common Stock on a one-to-one basis immediately prior to the completion of the Issuer's initial public offering of Class A 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.
F2 Consists of shares held by SB and HB, Co-Trustees of the Biswas Family Trust u/a/d 7/13/2012, over which Mr. Biswas has voting or investment power.
F3 Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Biswas Trust I u/a/d 11/11/2021, over which Mr. Biswas has voting or investment power.
F4 Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Biswas Trust II u/a/d 10/14/2021, over which Mr. Biswas has voting or investment power.
F5 Consists of shares held by HB, Trustee of The HB 2020 Annuity Trust u/a/d 12/2/2020, over which Mr. Biswas has voting or investment power.
F6 Consists of shares held by Sanjit Biswas, Trustee of The Sanjit Biswas 2020 Annuity Trust u/a/d 12/2/2020, over which Mr. Biswas has voting or investment power.
F7 Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Biswas Trust I-A u/a/d 11/11/2021, over which Mr. Biswas has voting or investment power.
F8 Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Biswas Trust I-A fbo REB u/a/d 11/11/2021, over which Mr. Biswas has voting or investment power.
F9 Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Biswas Trust I-A fbo NAmB u/a/d 11/11/2021, over which Mr. Biswas has voting or investment power.
F10 Consists of shares held by Jordan Park Trust Company, LLC, Trustee of The Biswas Trust I-A fbo NAlB u/a/d 11/11/2021, over which Mr. Biswas has voting or investment power.
F11 Consists of shares held by Mr. Biswas' spouse.
F12 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 and has no expiration date.