0001730168-21-000159.txt : 20211217
0001730168-21-000159.hdr.sgml : 20211217
20211217171538
ACCESSION NUMBER: 0001730168-21-000159
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211215
FILED AS OF DATE: 20211217
DATE AS OF CHANGE: 20211217
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Krause Thomas H.
CENTRAL INDEX KEY: 0001670643
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38449
FILM NUMBER: 211502610
MAIL ADDRESS:
STREET 1: 1320 RIDDER PARK
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_163977931455988.xml
FORM 4
X0306
4
2021-12-15
0
0001730168
Broadcom Inc.
AVGO
0001670643
Krause Thomas H.
C/O BROADCOM INC.
1320 RIDDER PARK DRIVE
SAN JOSE
CA
95131
0
1
0
0
President of Broadcom SW Group
Common Stock, $0.001 par value
2021-12-15
4
F
0
3585
639.86
D
50105
D
Common Stock, $0.001 par value
2021-12-16
4
S
0
3645
632.84
D
46460
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 46,460 RSUs.
Represents 46,460 RSUs.
/s/Noelle Matteson, Attorney-in-Fact for Thomas H. Krause, Jr.
2021-12-17