0001415889-24-019499.txt : 20240711 0001415889-24-019499.hdr.sgml : 20240711 20240711175549 ACCESSION NUMBER: 0001415889-24-019499 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240710 FILED AS OF DATE: 20240711 DATE AS OF CHANGE: 20240711 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LIVERMORE ANN M CENTRAL INDEX KEY: 0001207622 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41140 FILM NUMBER: 241112853 MAIL ADDRESS: STREET 1: C/O HEWLETT PACKARD ENTERPRISE CO STREET 2: 1701 E MOSSY OAKS ROAD CITY: SPRING STATE: TX ZIP: 77389 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Samsara Inc. CENTRAL INDEX KEY: 0001642896 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] ORGANIZATION NAME: 06 Technology IRS NUMBER: 473100039 STATE OF INCORPORATION: DE FISCAL YEAR END: 0201 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 form4-07112024_090746.xml X0508 4 2024-07-10 0001642896 Samsara Inc. IOT 0001207622 LIVERMORE ANN M C/O SAMSARA INC. 1 DE HARO STREET SAN FRANCISCO CA 94107 true false false false 0 Class A Common Stock 2024-07-10 4 A 0 5685 0 A 229739 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 July 10, 2025 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 Ann M. Livermore 2024-07-11