0001730168-21-000093.txt : 20210416
0001730168-21-000093.hdr.sgml : 20210416
20210416170151
ACCESSION NUMBER: 0001730168-21-000093
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210415
FILED AS OF DATE: 20210416
DATE AS OF CHANGE: 20210416
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: 21832250
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: 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_161860689716441.xml
FORM 4
X0306
4
2021-04-15
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
2021-04-15
4
F
0
9297
480
D
39353
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"), including performance stock units awards, previously granted to the Reporting Person.
Includes 26,750 RSUs.
/s/ Noelle Matteson, Attorney-in-Fact for Mark Brazeal
2021-04-16