Sec Form 4 Filing - Krause Thomas H. @ Broadcom Inc. - 2021-03-15

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Krause Thomas H.
2. Issuer Name and Ticker or Trading Symbol
Broadcom Inc. [ AVGO]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
President,Infrastructure SW Gp
(Last) (First) (Middle)
C/O BROADCOM INC., 1320 RIDDER PARK DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
03/15/2021
(Street)
SAN JOSE, CA95131
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, $0.001 par value 03/15/2021 A 15,625 ( 1 ) A $ 0 68,500 ( 2 ) D
Common Stock, $0.001 par value 03/15/2021 F 15,923 ( 3 ) D $ 470.77 52,577 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 400 D $ 468.234 ( 5 ) 52,177 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 30 D $ 469.35 52,147 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 654 D $ 471.199 ( 6 ) 51,493 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 902 D $ 472.036 ( 7 ) 50,591 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 776 D $ 473.058 ( 8 ) 49,815 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 646 D $ 474.348 ( 9 ) 49,169 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 1,226 D $ 476.802 ( 10 ) 47,943 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 1,354 D $ 477.73 ( 11 ) 46,589 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 1,711 D $ 478.658 ( 12 ) 44,878 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 2,170 D $ 479.964 ( 13 ) 42,708 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 1,600 D $ 480.7 ( 14 ) 41,108 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 3,026 D $ 481.85 ( 15 ) 38,082 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 2,132 D $ 482.574 ( 16 ) 35,950 ( 4 ) D
Common Stock, $0.001 par value 03/16/2021 S 200 D $ 483.67 ( 17 ) 35,750 ( 4 ) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Krause Thomas H.
C/O BROADCOM INC.
1320 RIDDER PARK DRIVE
SAN JOSE, CA95131
President,Infrastructure SW Gp
Signatures
/s/Noelle Matteson, Attorney-in-Fact for Thomas H. Krause, Jr. 03/17/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )On March 15, 2021, the Compensation Committee of the Issuer determined the achievement of certain performance criteria, based on the Issuer's compound annual total stockholder return relative to the S&P 500 Index, and the number of restricted stock units ("RSUs") that vests with respect to the fou rth and final performance period pursuant to the terms of a performance stock unit award ("PSU award") granted on March 15, 2017 under the Avago Technologies Limited 2009 Equity Incentive Award Plan. The RSUs are subject to time-based vesting conditions and fully vested on March 15, 2021, subject to the Reporting Person's continued service through such date. The Reporting Person is entitled to one (1) share of common stock of the Issuer for each one (1) RSU.
( 2 )Represents 68,500 RSUs.
( 3 )Consists of shares withheld by the Issuer to satisfy the tax withholding obligations of the Reporting Person upon the vesting of the relevant RSUs, including PSU awards, previously granted to the Reporting Person.
( 4 )Includes 35,750 RSUs.
( 5 )Transaction executed in multiple trades at prices ranging from $467.98 to $468.83 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 6 )Transaction executed in multiple trades at prices ranging from $470.70 to $471.67 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 7 )Transaction executed in multiple trades at prices ranging from $471.71 to $472.60 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 8 )Transaction executed in multiple trades at prices ranging from $472.76 to $473.66 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 9 )Transaction executed in multiple trades at prices ranging from $473.84 to $474.82 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 10 )Transaction executed in multiple trades at prices ranging from $476.25 to $477.24 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 11 )Transaction executed in multiple trades at prices ranging from $477.25 to $478.22 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 12 )Transaction executed in multiple trades at prices ranging from $478.26 to $479.14 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 13 )Transaction executed in multiple trades at prices ranging from $479.27 to $480.26 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 14 )Transaction executed in multiple trades at prices ranging from $480.30 to $481.29 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 15 )Transaction executed in multiple trades at prices ranging from $481.35 to $482.33 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 16 )Transaction executed in multiple trades at prices ranging from $482.42 to $483.35 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.
( 17 )Transaction executed in multiple trades at prices ranging from $483.54 to $483.80 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote.

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 4(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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