1. Name and Address of Reporting Person*
C/O GENERAL CATALYST PARTNERS |
20 UNIVERSITY ROAD, 4TH FLOOR |
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 12/14/2021
|
3. Issuer Name and Ticker or Trading Symbol
Samsara Inc.
[ IOT ]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
5. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
|
1. Name and Address of Reporting Person*
C/O GENERAL CATALYST PARTNERS |
20 UNIVERSITY ROAD, 4TH FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O GENERAL CATALYST PARTNERS |
20 UNIVERSITY ROAD 4TH FLOOR, |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
20 UNIVERSITY RD, SUITE 450, |
|
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O GENERAL CATALYST PARTNERS |
20 UNIVERSITY ROAD 4TH FLOOR, |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O GENERAL CATALYST PARTNERS |
20 UNIVERSITY ROAD 4TH FLOOR, |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
|
General Catalyst Group VIII, LP, By: General Catalyst Partners VIII, L.P., Its General Partner, By: General Catalyst GP VIII, LLC, Its General Partner; By: Christopher McCain |
12/14/2021 |
|
General Catalyst Group VIII Supplemental, L.P., By: General Catalyst Partners VIII, L.P., Its General Partner, By: General Catalyst GP VIII, LLC, Its General Partner; By: Christopher McCain |
12/14/2021 |
|
GC Ventures VIII, LLC, By: GC Venture VIII Manager, LLC, Its Manager, By: General Catalyst Group Management, LLC, Its Manager; By: Christopher McCain |
12/14/2021 |
|
GC Ventures VIII-B, LLC, By: GC Venture VIII-B Manager, LLC, Its Manager, By: General Catalyst Group Management, LLC, Its Manager; By: Christopher McCain |
12/14/2021 |
|
General Catalyst Group X - Endurance, L.P., By: General Partner for General Catalyst Partners X - Growth Ventures, L..P., By: General Catalyst GP X - Growth Ventures LLC, its General Partner, By: /s/ Christopher McCain |
12/14/2021 |
|
** Signature of Reporting Person |
Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* If the form is filed by more than one reporting person,
see
Instruction
5
(b)(v). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |