0001730168-21-000150.txt : 20211216
0001730168-21-000150.hdr.sgml : 20211216
20211216171306
ACCESSION NUMBER: 0001730168-21-000150
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211214
FILED AS OF DATE: 20211216
DATE AS OF CHANGE: 20211216
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FERNANDEZ RAUL J
CENTRAL INDEX KEY: 0001106627
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38449
FILM NUMBER: 211498498
MAIL ADDRESS:
STREET 1: 11600 SUNRISE VALLEY DR
CITY: RESTON
STATE: VA
ZIP: 20191
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_163969276263361.xml
FORM 4
X0306
4
2021-12-14
0
0001730168
Broadcom Inc.
AVGO
0001106627
FERNANDEZ RAUL J
C/O BROADCOM INC.
1320 RIDDER PARK DRIVE
SAN JOSE
CA
95131
1
0
0
0
Common Stock, $0.001 par value
2021-12-14
4
P
0
81
612.61
A
2302
D
Common Stock, $0.001 par value
2021-12-15
4
P
0
81
615
A
2383
D
Includes 476 restricted stock units.
/s/ Noelle Matteson, Attorney-in-Fact for Raul J. Fernandez
2021-12-16