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Samueli Henry – ‘4’ for 12/15/23 re: Broadcom Inc.

On:  Tuesday, 12/19/23, at 4:15pm ET   ·   For:  12/15/23   ·   As:  Director   ·   Accession #:  1104659-23-127325   ·   File #:  1-38449

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

12/19/23  Samueli Henry                     4          Director    1:8K   Broadcom Inc.                     Toppan Merrill/FA

Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 4   —   SEA’34

Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 4           Ownership Document -- tm2333085-2_4seq1.xml/5.8     HTML      9K


        

This ‘4’ Document is an XML Data File that may be rendered in various formats:

  Form 4    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 
 
SEC Info℠ rendering:  Ownership Document — tm2333085-2_4seq1.xml/5.8
 

The SEC has not released XSLT Stylesheets needed to render this File’s XML Data as a Form.

This is our “Plain Text” rendering:
 
                                                                                                                                                                                
Ownership Document
 
Schema Version:  X0508
Document Type:  4
Period of Report:  12/15/23
Not Subject to Section 16:  0
Issuer:
Issuer CIK:  1730168
Issuer Name:  Broadcom Inc.
Issuer Trading Symbol:  AVGO
Reporting Owner:
Reporting Owner ID:
Owner CIK:  1201633
Owner Name:  SAMUELI HENRY
Reporting Owner Address:
Owner Street 1:  C/O BROADCOM INC.
Owner Street 2:  3421 HILLVIEW AVENUE
Owner City:  PALO ALTO
Owner State:  CA
Owner ZIP Code:  94304
Owner State Description:
Reporting Owner Relationship:
Is Director?  Yes
Is Officer?  No
Is Ten Percent Owner?  No
Is Other?  No
Officer Title:
Other Text:
Aff 10b5 One:  0
Non-Derivative Table:
Non-Derivative Transaction:
Security Title:
Value:  Common Stock, $0.001 par value
Transaction Date:
Value:  12/15/23
Deemed Execution Date:
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  G
Equity Swap Involved?  No
Transaction Timeliness:
Transaction Amounts:
Transaction Shares:
Value:  14,385
Transaction Price Per Share:
Value:  0
Transaction Acquired-Disposed Code:
Value:  D
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  4,010,564
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  See Footnote
Footnote ID:  F1
Non-Derivative Transaction:
Security Title:
Value:  Common Stock, $0.001 par value
Transaction Date:
Value:  12/18/23
Deemed Execution Date:
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  G
Equity Swap Involved?  No
Transaction Timeliness:
Transaction Amounts:
Transaction Shares:
Value:  1,800
Transaction Price Per Share:
Value:  0
Transaction Acquired-Disposed Code:
Value:  D
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  4,008,764
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  See Footnote
Footnote ID:  F1
Non-Derivative Transaction:
Security Title:
Value:  Common Stock, $0.001 par value
Transaction Date:
Value:  12/18/23
Deemed Execution Date:
Transaction Coding:
Transaction Form Type:  4
Transaction Code:  G
Equity Swap Involved?  No
Transaction Timeliness:
Transaction Amounts:
Transaction Shares:
Value:  1,800
Transaction Price Per Share:
Value:  0
Transaction Acquired-Disposed Code:
Value:  D
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  3,157,399
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  See Footnote
Footnote ID:  F2
Non-Derivative Holding:
Security Title:
Value:  Common Stock, $0.001 par value
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  1,227,203
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  See Footnote
Footnote ID:  F3
Non-Derivative Holding:
Security Title:
Value:  Common Stock, $0.001 par value
Post-Transaction Amounts:
Shares Owned Following Transaction:
Value:  459,690
Ownership Nature:
Direct or Indirect Ownership:
Value:  I
Nature of Ownership:
Value:  See Footnote
Footnote ID:  F4
Footnotes:
Footnote - F1:  Directly held by D95GT LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
Footnote - F2:  Directly held by H&S Investments I L.P. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
Footnote - F3:  Directly held by E95GT LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.
Footnote - F4:  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.
Owner Signature:
Signature Name:  /s/ Michael J. Sorrow, Attorney-in-fact for Henry S. Samueli
Signature Date:  12/19/23


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