0001730168-18-000021.txt : 20180615 0001730168-18-000021.hdr.sgml : 20180615 20180615172538 ACCESSION NUMBER: 0001730168-18-000021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180613 FILED AS OF DATE: 20180615 DATE AS OF CHANGE: 20180615 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ingram Bryan CENTRAL INDEX KEY: 0001469468 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38449 FILM NUMBER: 18903121 MAIL ADDRESS: STREET 1: C/O AVAGO TECHNOLOGIES LIMITED STREET 2: 350 WEST TRIMBLE ROAD, BLDG. 90 CITY: SAN JOSE STATE: CA ZIP: 95131 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Broadcom Inc. CENTRAL INDEX KEY: 0001730168 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1031 BUSINESS ADDRESS: STREET 1: 1320 RIDDER PARK DRIVE CITY: SAN JOSE STATE: CA ZIP: 95131 BUSINESS PHONE: 408-433-8000 MAIL ADDRESS: STREET 1: 1320 RIDDER PARK DRIVE CITY: SAN JOSE STATE: CA ZIP: 95131 FORMER COMPANY: FORMER CONFORMED NAME: Broadcom Ltd DATE OF NAME CHANGE: 20180201 4 1 wf-form4_152909792127323.xml FORM 4 X0306 4 2018-06-13 0 0001730168 Broadcom Inc. AVGO 0001469468 Ingram Bryan C/O BROADCOM INC. 1320 RIDDER PARK DRIVE SAN JOSE CA 95131 0 1 0 0 SVP & GM, Wireless Semicon Div Common Stock, $0.001 par value 2018-06-13 4 M 0 20000 62.02 A 97936 D Common Stock, $0.001 par value 2018-06-13 4 S 0 7900 261.314 D 90036 D Common Stock, $0.001 par value 2018-06-13 4 S 0 12100 262.191 D 77936 D Stock Option (Right to Buy) 62.02 2018-06-13 4 M 0 20000 0 D 2021-03-10 Common Stock, $0.001 par value 20000.0 40000 D Transaction made pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person. Includes 40,375 Restricted Stock Units. Transaction executed in multiple trades at prices ranging from $260.98 to $261.97 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote. Transaction executed in multiple trades at prices ranging from $261.98 to $262.42 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote. Share price performance option (the "2014 Option") granted pursuant to the Avago Technologies Limited 2009 Equity Incentive Award Plan. The 2014 Option is fully vested and the exercisability requirements for the 2014 Option have been met. /s/ Noelle Matteson, Attorney-in-Fact for Bryan Ingram 2018-06-15 EX-24 2 poa.htm POWER OF ATTORNEY FOR: /S/ NOELLE MATTESON, ATTORNEY-IN-FACT FOR BRYAN INGRAM
POWER OF ATTORNEY

Know all by these presents, that the undersigned hereby constitutes and appoints each of (i) the Chief Financial Officer of Broadcom Inc., a Delaware corporation (the "Company"), and who is currently Thomas H. Krause, (ii) the Company's Chief Legal Officer, who is current Mark Brazeal, (iii) the Company's Vice President of Human Resources, who is currently Debbie Streeter, (iv) the Company's Deputy General Counsel, Corporate, who is currently Rebecca Boyden, and (v) the Company's Associate General Counsel, Corporate & Securities, who is currently Noelle Matteson, and their respective successors (including anyone serving in such capacities on an interim or acting basis), signing singly, with full powers of substitution, as the undersigned's true and lawful attorney-in-fact to:

1.    prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC;

2.    execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of the Company, and/or 10% holder of the Company's capital stock, Forms 3, 4, and 5 and any amendments thereto in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;

3.    do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and

4.    take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.

The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 4th day of April, 2018.

/s/     Bryan T. Ingram
By:   Bryan T. Ingram