0001209191-23-040352.txt : 20230630 0001209191-23-040352.hdr.sgml : 20230630 20230630165215 ACCESSION NUMBER: 0001209191-23-040352 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230629 FILED AS OF DATE: 20230630 DATE AS OF CHANGE: 20230630 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BOSTROM SUSAN L CENTRAL INDEX KEY: 0001181469 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41140 FILM NUMBER: 231062453 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Samsara Inc. CENTRAL INDEX KEY: 0001642896 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] 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 doc4.xml FORM 4 SUBMISSION X0407 4 2023-06-29 0 0001642896 Samsara Inc. IOT 0001181469 BOSTROM SUSAN L C/O SAMSARA INC. 1 DE HARO STREET SAN FRANCISCO CA 94107 1 0 0 0 0 Class A Common Stock 2023-06-29 4 A 0 7233 0.00 A 264054 D These securities are restricted stock units (RSUs). Each RSU represents a contingent right to receive one share of Class A Common Stock. The RSUs will vest in full on the earlier of June 29, 2024 or the day prior to the date of the Issuer's next annual meeting of stockholders, subject to the Reporting Person continuing as a service provider through the applicable vesting date. 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. /s/ Adam Eltoukhy, attorney-in-fact on behalf of Susan L. Bostrom 2023-06-30