0001730168-21-000141.txt : 20210929 0001730168-21-000141.hdr.sgml : 20210929 20210929162301 ACCESSION NUMBER: 0001730168-21-000141 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210927 FILED AS OF DATE: 20210929 DATE AS OF CHANGE: 20210929 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: 211291961 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_163294696777783.xml FORM 4 X0306 4 2021-09-27 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 2021-09-27 4 S 0 3150 504.092 D 26750 D Transaction executed in multiple trades at prices ranging from $504.04 to $504.17 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. Represents 26,750 restricted stock units. /s/ Noelle Matteson, Attorney-in-Fact for Mark Brazeal 2021-09-29