SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Spears Kirsten M.

(Last) (First) (Middle)
C/O BROADCOM INC.
1320 RIDDER PARK DRIVE

(Street)
SAN JOSE CA 95131

(City) (State) (Zip)
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)
VP CFO & Chief Accounting Ofcr
3. Date of Earliest Transaction (Month/Day/Year)
03/02/2022
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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 03/02/2022 A 3,250(1) A $0 36,710(2) D
Common Stock, $0.001 par value 03/02/2022 A 1,562(3) A $0 38,272(4) D
Common Stock, $0.001 par value 03/02/2022 A 1,562(5) A $0 39,834(6) D
Common Stock, $0.001 par value 03/02/2022 A 1,562(7) A $0 41,396(8) D
Common Stock, $0.001 par value 03/02/2022 A 6,250(9) A $0 47,646(10) 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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: 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
Explanation of Responses:
1. On March 2, 2022, the Compensation Committee of the Issuer determined the achievement of certain performance criteria, based on the Issuer's compound annual total stockholder return ("TSR") relative to the S&P 500 Index, and the number of restricted stock units ("RSUs") that will vest with respect to the second of four performance periods pursuant to the terms of a performance stock unit award ("PSU award") granted on December 15, 2020, under the LSI Corporation 2003 Equity Incentive Plan. The RSUs are subject to time-based vesting conditions and will vest in full on December 15, 2022, subject to the Reporting Person's continued service through such date. Upon vesting thereof, the Reporting Person is entitled to one (1) share of common stock for each one (1) RSU.
2. Includes 34,561 RSUs.
3. On March 2, 2022, the Compensation Committee of the Issuer determined the achievement of certain performance criteria, based on the Issuer's TSR relative to the S&P 500 Index, and the number of RSUs that will vest with respect to the first of four performance periods pursuant to the terms of a PSU award granted on January 15, 2019, under the Avago Technologies Limited 2009 Equity Incentive Award Plan ("2009 Avago Plan"). The RSUs are subject to time-based vesting conditions and will vest in full on March 15, 2022, subject to the Reporting Person's continued service through such date. Upon vesting thereof, the Reporting Person is entitled to one (1) share of common stock for each one (1) RSU.
4. Includes 36,123 RSUs.
5. On March 2, 2022, the Compensation Committee of the Issuer determined the achievement of certain performance criteria, based on the Issuer's TSR relative to the S&P 500 Index, and the number of RSUs that will vest with respect to the second of four performance periods pursuant to the terms of a PSU award granted on January 15, 2019, under the 2009 Avago Plan. The RSUs are subject to time-based vesting conditions and will vest in full on March 15, 2022, subject to the Reporting Person's continued service through such date. Upon vesting thereof, the Reporting Person is entitled to one (1) share of common stock for each one (1) RSU.
6. Includes 37,685 RSUs.
7. On March 2, 2022, the Compensation Committee of the Issuer determined the achievement of certain performance criteria, based on the Issuer's TSR relative to the S&P 500 Index, and the number of RSUs that will vest with respect to the third of four performance periods pursuant to the terms of a PSU award granted on January 15, 2019 under the 2009 Avago Plan. The RSUs are subject to time-based vesting conditions and will vest in full on March 15, 2022, subject to the Reporting Person's continued service through such date. Upon vesting thereof, the Reporting Person is entitled to one (1) share of common stock for each one (1) RSU.
8. Includes 39,247 RSUs.
9. On March 2, 2022, the Compensation Committee of the Issuer determined the achievement of certain performance criteria, based on the Issuer's TSR relative to the S&P 500 Index, and the number of RSUs that will vest with respect to the fourth and final performance period pursuant to the terms of a PSU award granted on March 15, 2018, under the 2009 Avago Plan. The RSUs are subject to time-based vesting conditions and will vest in full on March 15, 2022, subject to the Reporting Person's continued service through such date. Upon vesting thereof, the Reporting Person is entitled to one (1) share of common stock for each one (1) RSU.
10. Includes 45,497 RSUs.
Remarks:
/s/ Noelle Matteson, Attorney-in-Fact for Kirsten M. Spears 03/04/2022
** 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 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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