0001730168-19-000124.txt : 20191017 0001730168-19-000124.hdr.sgml : 20191017 20191017171631 ACCESSION NUMBER: 0001730168-19-000124 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191015 FILED AS OF DATE: 20191017 DATE AS OF CHANGE: 20191017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TAN HOCK E CENTRAL INDEX KEY: 0001211588 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38449 FILM NUMBER: 191155900 MAIL ADDRESS: STREET 1: C/O AVAGO TECHNOLOGIES U.S. INC. STREET 2: 1320 RIDDER PARK DRIVE 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: 1103 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_157134695977021.xml FORM 4 X0306 4 2019-10-15 0 0001730168 Broadcom Inc. AVGO 0001211588 TAN HOCK E C/O BROADCOM INC. 1320 RIDDER PARK DRIVE SAN JOSE CA 95131 1 1 0 0 President and CEO Common Stock, $0.001 par value 2019-10-15 4 M 0 20000 38.99 A 246852 D Common Stock, $0.001 par value 2019-10-15 4 S 0 1057 283.087 D 245795 D Common Stock, $0.001 par value 2019-10-15 4 S 0 1368 284.382 D 244427 D Common Stock, $0.001 par value 2019-10-15 4 S 0 800 285.483 D 243627 D Common Stock, $0.001 par value 2019-10-15 4 S 0 2200 286.933 D 241427 D Common Stock, $0.001 par value 2019-10-15 4 S 0 5330 287.621 D 236097 D Common Stock, $0.001 par value 2019-10-15 4 S 0 2900 288.905 D 233197 D Common Stock, $0.001 par value 2019-10-15 4 S 0 6345 289.788 D 226852 D Stock Option (Right to Buy) 38.99 2019-10-15 4 M 0 20000 38.99 D 2020-09-21 Common Stock, $0.001 par value 20000.0 1229166 D Transaction made pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person. Includes 3,004 Restricted Stock Units. Transaction executed in multiple trades at prices ranging from $282.82 to $283.37 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 $283.84 to $284.66 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 $284.90 to $285.88 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 $286.32 to $287.26 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 $287.34 to $288.15 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 $288.43 to $289.40 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 $289.47 to $290.13 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 granted pursuant to the Avago Technologies Limited 2009 Equity Incentive Award Plan. This option is fully vested and the exercisability requirements for this option have been met. /s/ Noelle Matteson, Attorney-in-Fact for Hock E. Tan 2019-10-17