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