0001837240-24-000142.txt : 20240611 0001837240-24-000142.hdr.sgml : 20240611 20240611192420 ACCESSION NUMBER: 0001837240-24-000142 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240607 FILED AS OF DATE: 20240611 DATE AS OF CHANGE: 20240611 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ford Rollin L. CENTRAL INDEX KEY: 0001429247 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40175 FILM NUMBER: 241037181 MAIL ADDRESS: STREET 1: 702 S.W. 8TH STREET STREET 2: MAIL STOP # 0215 CITY: BENTONVILLE STATE: AR ZIP: 72716-0215 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Symbotic Inc. CENTRAL INDEX KEY: 0001837240 STANDARD INDUSTRIAL CLASSIFICATION: GENERAL INDUSTRIAL MACHINERY & EQUIPMENT, NEC [3569] ORGANIZATION NAME: 06 Technology IRS NUMBER: 981572401 STATE OF INCORPORATION: DE FISCAL YEAR END: 0928 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_1718148252.xml FORM 4 X0508 4 2024-06-07 0 0001837240 Symbotic Inc. SYM 0001429247 Ford Rollin L. C/O SYMBOTIC INC., 200 RESEARCH DRIVE WILMINGTON MA 01887 1 0 0 0 0 Class V-1 Common Stock 2024-06-07 4 J 0 49998 D 1106532 I By Spouse Class A Common Stock 2024-06-07 4 J 0 49998 A 49998 I By Spouse Class A Common Stock 2024-06-07 4 S 0 49998 37.2899 D 0 I By Spouse Class A Common Stock 8000 I By Rollin L Ford Trust Class A Common Stock 30000 I By Spouse Class A Common Stock 10447 D Symbotic Holdings Units 2024-06-07 4 J 0 49998 D Class A Common Stock 49998 1106532 I By Spouse 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 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. 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. 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. 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. 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. 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. 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. /s/ Corey Dufresne, as Attorney-in-Fact for Reporting Person 2024-06-11