0001730168-23-000086.txt : 20231107 0001730168-23-000086.hdr.sgml : 20231107 20231107173716 ACCESSION NUMBER: 0001730168-23-000086 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231103 FILED AS OF DATE: 20231107 DATE AS OF CHANGE: 20231107 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: 231385272 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: 352617337 FISCAL YEAR END: 1029 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 wk-form4_1699396627.xml FORM 4 X0508 4 2023-11-03 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 President, Semi Solutions Grp 0 Common Stock, $0.001 par value 2023-11-03 4 A 0 35880 0 A 111170 D Common Stock, $0.001 par value 2023-11-03 4 F 0 17790 882.68 D 93380 D Common Stock, $0.001 par value 55 I By Child 1 Common Stock, $0.001 par value 55 I By Child 2 Common Stock, $0.001 par value 55 I By spouse as custodian for Child 3 Common Stock, $0.001 par value 55 I By spouse as custodian for Child 4 Restricted stock units (RSUs) earned pursuant to performance stock units achieving certain performance criteria that are based on the Issuer's total stockholder return relative to the S & P 500 Index. Includes 20,980 RSUs. /s/ Noelle Matteson, Attorney-in-Fact for Charlie B Kawwas 2023-11-07