Broadcom Inc. — Director's Dealing 2018

Apr 17, 2018

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: Broadcom Inc. (AVGO)
CIK: 0001730168
Period of Report: 2018-04-13

Reporting Person: SAMUELI HENRY (Director, Chief Technical Officer)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2018-04-13	Common Stock, $0.001 par value	J	24494	$248.45	Disposed	15564.5	Indirect
2018-04-13	Common Stock, $0.001 par value	J	24494	$248.45	Disposed	15564.5	Indirect

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock, $0.001 par value	2815760	Indirect
Common Stock, $0.001 par value	254338	Direct
Common Stock, $0.001 par value	5752978	Indirect
Common Stock, $0.001 par value	399918	Indirect
Common Stock, $0.001 par value	459690	Indirect
Common Stock, $0.001 par value	1860	Indirect

Footnotes

F1: Indirectly held by Henry Samueli 2016 GRAT, a trust for which the Reporting Person is trustee, through ownership of membership interests in HS REU, LLC, the direct holder of the common stock. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

F2: Indirectly held by Susan Faye Samueli 2016 GRAT, a trust for which the Reporting Person's spouse is trustee, through ownership of membership interests in SFS REU, LLC, the direct holder of the common stock. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest.

F3: Directly held by H&S Investments I L.P. and through its ownership of membership interests in HS REU, LLC and SFS REU, LLC, direct holders of certain shares of common stock. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

F4: Includes 73,496 restricted stock units.

F5: Directly held by HS Portfolio L.P. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

F6: Directly held by HS Management, L.P. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

F7: Directly held by H&S Portfolio II L.P. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

F8: Directly held by H&S Ventures LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

F9: Change in form of beneficial ownership as a result of property substitution.

F10: Includes 48,988 shares transferred in connection with a change in form of beneficial ownership for no consideration which was exempt from Section 16 pursuant to Rule 16a-13 under the Securities Exchange Act of 1934, as amended.