0001730168-19-000064.txt : 20190321 0001730168-19-000064.hdr.sgml : 20190321 20190321201209 ACCESSION NUMBER: 0001730168-19-000064 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190319 FILED AS OF DATE: 20190321 DATE AS OF CHANGE: 20190321 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kawwas Charlie B CENTRAL INDEX KEY: 0001608425 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38449 FILM NUMBER: 19698184 MAIL ADDRESS: STREET 1: C/O AVAGO TECHNOLOGIES U.S. INC. STREET 2: 350 WEST TRIMBLE ROAD 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_155321351459105.xml FORM 4 X0306 4 2019-03-19 0 0001730168 Broadcom Inc. AVGO 0001608425 Kawwas Charlie B C/O BROADCOM INC. 1320 RIDDER PARK DRIVE SAN JOSE CA 95131 0 1 0 0 SVP & Chief Sales Officer Common Stock, $0.001 par value 2019-03-19 4 M 0 3668 38.92 A 109477 D Common Stock, $0.001 par value 2019-03-19 4 M 0 5662 62.63 A 115139 D Common Stock, $0.001 par value 2019-03-19 4 S 0 9330 295.925 D 105809 D Stock Option (Right to Buy) 38.92 2019-03-19 4 M 0 3668 0 D 2020-03-01 Common Stock, $0.001 par value 3668.0 0 D Stock Option (Right to Buy) 62.63 2019-03-19 4 M 0 5662 0 D 2021-03-01 Common Stock, $0.001 par value 5662.0 0 D Includes 62,625 Restricted Stock Units. Transaction executed in multiple trades at prices ranging from $295.76 to $296.12 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. The option is fully vested and exercisable. /s/ Noelle Matteson, Attorney-In-Fact for Charlie B Kawwas 2019-03-21