SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Palkhiwala Akash J.

(Last) (First) (Middle)
5775 MOREHOUSE DR.

(Street)
SAN DIEGO CA 92121-1714

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/23/2019
3. Issuer Name and Ticker or Trading Symbol
QUALCOMM INC/DE [ QCOM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP & Interim CFO
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 18,462 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Phantom Stock Unit(1) (2) (3) Common Stock 2,509.58 0.0 I by Grantor Trust(1)
Restricted Stock Unit (4) 11/20/2019(4) Common Stock 1,901.282 (5) D
Restricted Stock Unit (6) 11/20/2020(6) Common Stock 7,143.7521 (5) D
Restricted Stock Unit (7) 05/20/2021(7) Common Stock 9,101.2725 (5) D
Restricted Stock Unit (8) 11/20/2021(8) Common Stock 13,518.9215 (5) D
Explanation of Responses:
1. The common stock issued under the terms of the Company's Non-Qualified Deferred Compensation Plan, a tax conditioned plan, is exempt under Rule 16b-3. The shares are held in a grantor trust and stock is the only permissible form of distribution under the Plan.
2. The rights awarded under the Company's Non-Qualified Deferred Compensation Plan will be eligible for distribution upon termination and vest 100% after 2 years of continuous service with the Company.
3. The rights awarded under the Company's Non-Qualified Deferred Compensation Plan will be eligible for distribution upon termination.
4. The Restricted Stock Units (and allocable dividend equivalents) vested one-third on November 20, 2017, and the remaining balance vests semi-annually thereafter.
5. Each Restricted Stock Unit is the economic equivalent of one share of Qualcomm common stock and is converted into common stock upon vesting.
6. The Restricted Stock Units (and allocable dividend equivalents) vested one-third on November 20, 2018, and the remaining balance vests semi-annually thereafter.
7. The Restricted Stock Units (and allocable dividend equivalents) vest in equal one-third amounts on May 20, 2019, 2020 and 2021.
8. The Restricted Stock Units (and allocable dividend equivalents) vest one-third on November 20, 2019, and the remaining balance vests semi-annually thereafter.
By: David Zuckerman, Attorney-in-Fact For: Akash J. Palkhiwala 08/26/2019
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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