SEC FORM 4

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

1. Name and Address of Reporting Person^*

Ford Rollin L.

(Last)

(First)

(Middle)

C/O SYMBOTIC INC., 200 RESEARCH DRIVE

(Street)

WILMINGTON

01887

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Symbotic Inc. [ SYM ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
06/07/2024

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Class V-1 Common Stock⁽¹⁾⁽²⁾	06/07/2024		J⁽¹⁾⁽²⁾⁽³⁾		49,998	D	⁽¹⁾⁽²⁾⁽³⁾	1,106,532	I	By Spouse⁽⁴⁾
Class A Common Stock	06/07/2024		J⁽¹⁾⁽²⁾⁽³⁾		49,998	A	⁽¹⁾⁽²⁾⁽³⁾	49,998	I	By Spouse⁽⁵⁾
Class A Common Stock	06/07/2024		S		49,998	D	$37.2899⁽⁶⁾	0	I	By Spouse⁽⁵⁾
Class A Common Stock								8,000	I	By Rollin L Ford Trust
Class A Common Stock								30,000	I	By Spouse⁽⁷⁾
Class A Common Stock								10,447	D

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Symbotic Holdings Units⁽¹⁾⁽²⁾⁽³⁾	⁽¹⁾⁽²⁾	06/07/2024		J⁽¹⁾⁽²⁾⁽³⁾			49,998	⁽¹⁾⁽²⁾	⁽¹⁾⁽²⁾	Class A Common Stock	49,998	⁽¹⁾⁽²⁾	1,106,532	I	By Spouse⁽⁸⁾

Explanation of Responses:

1. Shares of Class V-1 Common Stock of the Issuer have no economic rights and each share of Class V-1 Common Stock entitles its holder to 1 vote per share.

2. The term "Symbotic Holdings Units" is used herein to represent limited liability company units of Symbotic Holdings and an equal number of paired shares of Class V-1 Common Stock of the Issuer, which, pursuant to the limited liability company agreement of Symbotic Holdings, are together redeemable by the holder on a one-for-one basis for a share of Class A Common Stock of the Issuer, subject to conversion rate adjustments for stock splits, stock dividends, reclassification and other similar transactions, and in accordance with other terms and conditions set forth in Symbotic Holdings' Second Amended and Restated Limited Liability Company Agreement, dated as of June 7, 2022. Upon redemption, the Issuer will cancel the Symbotic Holdings Units and cancel and retire for no consideration the redeemed shares of Class V-1 Common Stock.

3. On June 7, 2024, each of the Audrey Exempt Trust, u/a, the Jessica Exempt Trust, u/a, and the Paige Exempt Trust, u/a, sold 16,666 shares of Class A Common Stock (the "Stock Sale"), In connection with the Stock Sale, effective June 7, 2024, each of the Audrey Exempt Trust, u/a, the Jessica Exempt Trust, u/a, and the Paige Exempt Trust, u/a, redeemed 16,666 Symbotic Holdings Units in exchange for an equal number of shares of Class A Common Stock (the "Stock Redemption"). In connection with the Stock Redemption, Symbotic Holdings canceled the Symbotic Holdings Units, and the Issuer canceled and retired for no consideration the redeemed 49,998 shares of Class V-1 Common Stock.

4. Rollin Ford may be considered to have an indirect pecuniary interest in the 368,844 Class V-1 common stock held by the Audrey Exempt Trust, u/a, 368,844 Class V-1 common stocks held by the Jessica Exempt Trust, u/a, and 368,844 Class V-1 common stock held by the Paige Exempt Trust, u/a (collectively the "Trust V-1 Shares"), each of which has Mr. Ford's spouse as a Trustee and to which members of Mr. Ford's immediate family have a pecuniary interest. Rollin Ford does not have voting or investment control over the Trust Shares and disclaims beneficial ownership of the Trust V-1 Shares 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 Trust V-1 Shares for purposes of Section 16 or for any other purpose.

5. Rollin Ford may be considered to have an indirect pecuniary interest in the Class A common stock held by the Audrey Exempt Trust, u/a, the Class A common stock held by the Jessica Exempt Trust, u/a, and Class A common stock held by the Paige Exempt Trust, u/a (collectively the "Trust Common Stock"), each of which has Mr. Ford's spouse as a Trustee and to which members of Mr. Ford's immediate family have a pecuniary interest. Rollin Ford does not have voting or investment control over the Trust Shares and disclaims beneficial ownership of the Trust Shares 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 Trust Common Stock for purposes of Section 16 or for any other purpose.

6. In accordance with SEC guidance authorizing aggregate reporting of same-day purchases and sales, the shares were sold in multiple transactions at prices ranging from $37.00 to $37.60, inclusive. The Reporting Person undertakes to provide the Issuer, any security holder of the Issuer or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.

7. 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.

8. Rollin Ford may be considered to have an indirect pecuniary interest in the 368,844 Symbotic Holdings Units held by the Audrey Exempt Trust, u/a, 368,844 Symbotic Holdings Units held by the Jessica Exempt Trust, u/a, and 368,844 Symbotic Holdings Units held by the Paige Exempt Trust, u/a (collectively the "Trust Units"), each of which has Mr. Ford's spouse as a Trustee and to which members of Mr. Ford's immediate family have a pecuniary interest. Rollin Ford does not have voting or investment control over the Trust Units and disclaims beneficial ownership of the Trust Units 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 Trust Units for purposes of Section 16 or for any other purpose.

Remarks:

	/s/ Corey Dufresne, as Attorney-in-Fact for Reporting Person	06/11/2024
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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