0001730168-18-000027.txt : 20180628 0001730168-18-000027.hdr.sgml : 20180628 20180628173202 ACCESSION NUMBER: 0001730168-18-000027 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180627 FILED AS OF DATE: 20180628 DATE AS OF CHANGE: 20180628 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: 18926507 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_153022150641675.xml FORM 4 X0306 4 2018-06-27 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 2018-06-27 4 M 0 20000 62.02 A 87332 D Common Stock, $0.001 par value 2018-06-27 4 S 0 9714 250.329 D 77618 D Common Stock, $0.001 par value 2018-06-27 4 S 0 6086 251.554 D 71532 D Common Stock, $0.001 par value 2018-06-27 4 S 0 1900 252.253 D 69632 D Common Stock, $0.001 par value 2018-06-27 4 S 0 1600 253.689 D 68032 D Common Stock, $0.001 par value 2018-06-27 4 S 0 700 254.818 D 67332 D Stock Option (Right to Buy) 62.02 2018-06-27 4 M 0 20000 0 D 2021-03-10 Common Stock, $0.001 par value 20000.0 20000 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 $249.97 to $250.96 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 $250.97 to $251.95 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 $251.98 to $252.55 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 $253.23 to $254.15 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 $254.47 to $255.03 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 2018-06-28