0001730168-18-000067.txt : 20181218
0001730168-18-000067.hdr.sgml : 20181218
20181218171549
ACCESSION NUMBER: 0001730168-18-000067
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181214
FILED AS OF DATE: 20181218
DATE AS OF CHANGE: 20181218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: EGGEBRECHT LEWIS C
CENTRAL INDEX KEY: 0001213489
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38449
FILM NUMBER: 181241318
MAIL ADDRESS:
STREET 1: C/O INTEGRATED DEVICE TECHNOLOGY, INC.
STREET 2: 6024 SILVER CREEK VALLEY ROAD
CITY: SAN JOSE
STATE: CA
ZIP: 95138
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_154517133211243.xml
FORM 4
X0306
4
2018-12-14
0
0001730168
Broadcom Inc.
AVGO
0001213489
EGGEBRECHT LEWIS C
C/O BROADCOM INC.
1320 RIDDER PARK DRIVE
SAN JOSE
CA
95131
1
0
0
0
Common Stock, $0.001 par value
2018-12-14
4
M
0
5121
62.47
A
11954
D
Common Stock, $0.001 par value
2018-12-14
4
S
0
2000
260.81
D
9954
D
Common Stock, $0.001 par value
1500
I
See Footnote
Stock Option (Right to Buy)
62.47
2018-12-14
4
M
0
5121
0
D
2019-04-08
Common Stock, $0.001 par value
5121.0
0
D
Includes 807 Restricted Stock Units.
Shares held by Lewis and Rebecca Eggebrecht Living Trust dated 6/21/1997 for which the Reporting Person serves as Trustee.
The option vested over 3 years, with 33.333% vesting on each anniversary of the grant date of April 9, 2014, such that the option fully vested on April 9, 2017.
/s/ Noelle Matteson, Attorney-in-Fact for Lewis C. Eggebrecht
2018-12-18