0001288469-21-000235.txt : 20210927 0001288469-21-000235.hdr.sgml : 20210927 20210927194942 ACCESSION NUMBER: 0001288469-21-000235 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210927 FILED AS OF DATE: 20210927 DATE AS OF CHANGE: 20210927 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SEENDRIPU KISHORE CENTRAL INDEX KEY: 0001478340 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34666 FILM NUMBER: 211283198 MAIL ADDRESS: STREET 1: 5966 LA PLACE COURT STREET 2: SUITE 100 CITY: CARLSBAD STATE: CA ZIP: 92011 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MAXLINEAR INC CENTRAL INDEX KEY: 0001288469 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 141896129 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5966 LA PLACE CT. CITY: CARLSBAD STATE: CA ZIP: 92008 BUSINESS PHONE: 760-692-0711 MAIL ADDRESS: STREET 1: 5966 LA PLACE CT. CITY: CARLSBAD STATE: CA ZIP: 92008 4 1 wf-form4_163278656659719.xml FORM 4 X0306 4 2021-09-27 0 0001288469 MAXLINEAR INC MXL 0001478340 SEENDRIPU KISHORE C/O MAXLINEAR, INC. 5966 LA PLACE COURT, SUITE 100 CARLSBAD CA 92008 1 1 1 0 Chairman, President and CEO Common Stock 2021-09-27 5 G 0 E 5000 0 D 225364 D Common Stock 350092 I See footnote Common Stock 410731 I See footnote Common Stock 410731 I See footnote Common Stock 344997 I See footnote Common Stock 344997 I See footnote Common Stock 394891 I See footnote Common Stock 394891 I See footnoe Common Stock 396526 I See footnote Common Stock 396526 I See footnote Common Stock 18920 I See footnote Shares held by the Seendripu Family Trust dated 10/5/09, a trust for the benefit of the Reporting Person and the Reporting Person's spouse, for which the Reporting Person and the Reporting Person's spouse serve as trustees. Shares held by the Kishore V. Seendripu 2019 Annuity Trust dated May 6, 2019, a grantor retained annuity trust, for which the Reporting Person serves as trustee. Shares held by the Rekha S. Seendripu 2019 Annuity Trust dated May 6, 2019, a grantor retained annuity trust, for which the Reporting Person serves as trustee. Shares held by the Kishore V. Seendripu 2019-2 Annuity Trust dated November 9, 2019, a grantor retained annuity trust, for which the Reporting Person serves as trustee. Shares held by the Rekha S. Seendripu 2019-2 Annuity Trust dated November 9, 2019, a grantor retained annuity trust, for which the Reporting Person serves as trustee. Shares held by the Kishore V. Seendripu 2020 Annuity Trust A dated June 1, 2020, a grantor retained annuity trust, for which the Reporting Person serves as trustee. Shares held by the Rekha S. Seendripu 2020 Annuity Trust A dated June 1, 2020, a grantor retained annuity trust, for which the Reporting Person serves as trustee. Shares held by the IKS Heritage Trust dated July 13, 2020, a trust for the benefit of the Reporting Person's child, and for which the Reporting Person serves as co-trustee. Shares held by the SS Heritage Trust dated July 13, 2020, a trust for the benefit of the Reporting Person's child, and for which the Reporting Person serves as co-trustee. Shares held by the Seendripu Relatives Trust dated 10/5/09, a trust for the benefit of the Reporting Person's parents and siblings, and for which the Reporting Person serves as trustee. /s/ Connie Kwong, as Attorney-in-Fact 2021-09-27