FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 04/01/2013 |
3. Issuer Name and Ticker or Trading Symbol
BROADCOM CORP [ BRCM ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Class A common stock | 127,378(1)(2) | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Employee stock option (right to buy) | (3) | 05/04/2016 | Class A common stock | 30,000 | $41.15 | D | |
Employee stock option (right to buy) | (3) | 05/02/2017 | Class A common stock | 6,734 | $32.93 | D | |
Employee stock option (right to buy) | (3) | 04/23/2018 | Class A common stock | 14,650 | $27.74 | D | |
Employee stock option (right to buy) | (4) | 04/27/2019 | Class A common stock | 4,375 | $23.17 | D | |
Employee stock option (right to buy) | (5) | 02/04/2020 | Class A common stock | 28,296 | $29.39 | D | |
Employee stock option (right to buy) | (5) | 02/04/2020 | Class A common stock | 20,516 | $29.39 | D |
Explanation of Responses: |
1. Includes (i) 15,603 shares of the Issuer's Class A common stock, (ii) 1,094 shares in the form of restricted stock units ("RSUs") that will entitle the Reporting Person to receive one share of Class A common stock per RSU as all of such RSUs vest on 05/05/2013, (iii) 3,283 shares in the form of RSUs that will entitle the Reporting Person to receive one share of Class A common stock per RSU as the RSUs vest in a series of four quarterly installments from 05/05/2013 through 02/05/2014, (iv) 3,283 shares in the form of RSUs that will entitle the Reporting Person to receive one share of Class A common stock per RSU as all of such RSUs vest on 02/05/2014 (v) 11,031 shares in the form of RSUs that will entitle the Reporting Person to receive one share of Class A common stock per RSU as the RSUs vest in a series of eight quarterly installments from 05/05/2013 through 02/05/2015, |
2. (vi) 24,885 shares in the form of RSUs that will entitle the Reporting Person to receive one share of Class A common stock per RSU as the RSUs vest in a series of twelve quarterly installments from 05/05/2013 through 02/05/2016, (vii) 30,423 shares in the form of RSUs that will entitle the Reporting Person to receive one share of Class A common stock per RSU as all of such RSUs vest on 02/05/2016, (viii) 37,776 shares in the form of RSUs that will entitle the Reporting Person to receive one share of Class A common stock per RSU as the RSUs vest in a series of sixteen quarterly installments from 05/05/2013 through 02/05/2016. |
3. The option is fully vested and immediately exercisable. |
4. Such option was granted on 04/28/2009 and vests in equal monthly installments through 04/28/2013. |
5. Such option was granted on 02/05/2010 and vests in equal monthly installments through 02/05/2014. |
Remarks: |
/s/ Michael E. Hurlston | 04/01/2013 | |
** 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. |