0001837240-23-000214.txt : 20231215 0001837240-23-000214.hdr.sgml : 20231215 20231215172611 ACCESSION NUMBER: 0001837240-23-000214 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231213 FILED AS OF DATE: 20231215 DATE AS OF CHANGE: 20231215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KANE CHARLES CENTRAL INDEX KEY: 0001203561 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40175 FILM NUMBER: 231491466 MAIL ADDRESS: STREET 1: 289 TURNPIKE RD CITY: WESTBORO STATE: MA ZIP: 01581 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Symbotic Inc. CENTRAL INDEX KEY: 0001837240 STANDARD INDUSTRIAL CLASSIFICATION: GENERAL INDUSTRIAL MACHINERY & EQUIPMENT, NEC [3569] IRS NUMBER: 981572401 FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 200 RESEARCH DRIVE CITY: WILMINGTON STATE: MA ZIP: 01887 BUSINESS PHONE: 978-284-2800 MAIL ADDRESS: STREET 1: 200 RESEARCH DRIVE CITY: WILMINGTON STATE: MA ZIP: 01887 FORMER COMPANY: FORMER CONFORMED NAME: SVF Investment Corp. 3 DATE OF NAME CHANGE: 20210128 FORMER COMPANY: FORMER CONFORMED NAME: SVF Investment III Corp. DATE OF NAME CHANGE: 20201218 4 1 wk-form4_1702679161.xml FORM 4 X0508 4 2023-12-13 0 0001837240 Symbotic Inc. SYM 0001203561 KANE CHARLES C/O SYMBOTIC INC., 200 RESEARCH DRIVE WILMINGTON MA 01887 1 0 0 0 0 Class V-1 Common Stock 2023-12-13 4 G 0 5000 0 D 634353 D Symbotic Holdings Units 2023-12-13 4 G 0 5000 D Class A Common Stock 5000 634353 D 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. The term "Symbotic Holdings Units" is used herein to represent limited liability company units of Symbotic Holdings LLC ("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 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. Represents a bona fide gift to a charitable donor-advised fund. Price is not applicable to acquisitions or dispositions resulting from bona fide gifts. /s/ Corey Dufresne, Attorney-in-Fact for Charles Kane 2023-12-15