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Samueli Henry – ‘4’ for 1/4/21 re: Broadcom Inc.

On:  Thursday, 1/7/21, at 11:57am ET   ·   For:  1/4/21   ·   Accession #:  1104659-21-1916   ·   File #:  1-38449

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

 1/07/21  Samueli Henry                     4                      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 -- tm211951-1_4.xml/3.6          HTML      3K


        

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
 
 
XML Data rendering:  Ownership Document — tm211951-1_4.xml/3.6
 
                                                                                                                                                                                
<?xml version="1.0" encoding="windows-1252"?>
<ownershipDocument>
<schemaVersion> X0306 </schemaVersion>
<documentType> 4 </documentType>
<periodOfReport> 2021-01-04 </periodOfReport>
<notSubjectToSection16> 0 </notSubjectToSection16>
<issuer>
<issuerCik> 0001730168 </issuerCik>
<issuerName> Broadcom Inc. </issuerName>
<issuerTradingSymbol> AVGO </issuerTradingSymbol>
</issuer>
<reportingOwner>
<reportingOwnerId>
<rptOwnerCik> 0001201633 </rptOwnerCik>
<rptOwnerName> SAMUELI HENRY </rptOwnerName>
</reportingOwnerId>
<reportingOwnerAddress>
<rptOwnerStreet1> C/O BROADCOM INC. </rptOwnerStreet1>
<rptOwnerStreet2> 1320 RIDDER PARK DRIVE </rptOwnerStreet2>
<rptOwnerCity> SAN JOSE </rptOwnerCity>
<rptOwnerState> CA </rptOwnerState>
<rptOwnerZipCode> 95131 </rptOwnerZipCode>
<rptOwnerStateDescription></rptOwnerStateDescription>
</reportingOwnerAddress>
<reportingOwnerRelationship>
<isDirector> 1 </isDirector>
<isOfficer> 0 </isOfficer>
<isTenPercentOwner> 0 </isTenPercentOwner>
<isOther> 0 </isOther>
<officerTitle></officerTitle>
<otherText></otherText>
</reportingOwnerRelationship>
</reportingOwner>
<nonDerivativeTable>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock, $0.001 par value </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 262582 </value>
<footnoteId id="F1"/>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
</directOrIndirectOwnership>
</ownershipNature>
</nonDerivativeHolding>
<nonDerivativeTransaction>
<securityTitle>
<value> Common Stock, par value $0.001k </value>
</securityTitle>
<transactionDate>
<value> 2021-01-04 </value>
</transactionDate>
<deemedExecutionDate></deemedExecutionDate>
<transactionCoding>
<transactionFormType> 5 </transactionFormType>
<transactionCode> G </transactionCode>
<equitySwapInvolved> 0 </equitySwapInvolved>
</transactionCoding>
<transactionTimeliness>
<value> E </value>
</transactionTimeliness>
<transactionAmounts>
<transactionShares>
<value> 183600 </value>
</transactionShares>
<transactionPricePerShare>
<value> 0 </value>
</transactionPricePerShare>
<transactionAcquiredDisposedCode>
<value> D </value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 4444484 </value>
<footnoteId id="F4"/>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F2"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeTransaction>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock. $0.001 par value </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 1227203 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F3"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock, $0.001 par value </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 2893512 </value>
<footnoteId id="F4"/>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F5"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock, $0.001 par value </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 459690 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F6"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
<nonDerivativeHolding>
<securityTitle>
<value> Common Stock, $0.001 par value </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 0 </value>
<footnoteId id="F4"/>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> See Footnote </value>
<footnoteId id="F7"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
</nonDerivativeTable>
<footnotes>
<footnote id="F1"> Includes 2,183 restricted stock units. </footnote>
<footnote id="F2"> Directly held by D95GT LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. </footnote>
<footnote id="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>
<footnote id="F4"> Reflects change in form of beneficial ownership for no consideration in transaction exempt from Section 16 pursuant to Rule 16a-13 under the Securities Exchange Act of 1934. </footnote>
<footnote id="F5"> 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>
<footnote id="F6"> 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. </footnote>
<footnote id="F7"> 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. </footnote>
</footnotes>
<ownerSignature>
<signatureName> /s/ Henry S. Samueli by Anne G. Plimpton, Attorney in Fact </signatureName>
<signatureDate> 2021-01-06 </signatureDate>
</ownerSignature>
</ownershipDocument>


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