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