0001730168-20-000207.txt : 20201217 0001730168-20-000207.hdr.sgml : 20201217 20201217164421 ACCESSION NUMBER: 0001730168-20-000207 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201215 FILED AS OF DATE: 20201217 DATE AS OF CHANGE: 20201217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Brazeal Mark David CENTRAL INDEX KEY: 0001627720 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38449 FILM NUMBER: 201396613 MAIL ADDRESS: STREET 1: 1320 RIDDER PARK DRIVE 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: 1101 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_160824144609974.xml FORM 4 X0306 4 2020-12-15 0 0001730168 Broadcom Inc. AVGO 0001627720 Brazeal Mark David C/O BROADCOM INC. 1320 RIDDER PARK DRIVE SAN JOSE CA 95131 0 1 0 0 Chief Legal Officer Common Stock, $0.001 par value 2020-12-15 4 F 0 372 418.06 D 43705 D Common Stock, $0.001 par value 2020-12-15 4 S 0 4000 415.46 D 39705 D Consists of shares withheld by the Issuer to satisfy the tax withholding obligations of the Reporting Person upon the vesting of the relevant restricted stock units ("RSUs") previously granted to the Reporting Person. Includes 35,250 RSUs. /s/ Noelle Matteson, Attorney-in-Fact for Mark Brazeal 2020-12-17