|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
|
| |||||||||||||||||||||||||||||
|
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: 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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SWITZ ROBERT E 5300 CALIFORNIA AVENUE IRVINE, CA 92617 |
X |
/s/ Lauri D. Fischer, Attorney-in-fact | 05/14/2015 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The securities awarded on 05/12/2015 are in the form of restricted stock units that will entitle the Reporting Person to receive one share of Class A common stock per restricted stock unit upon the vesting of that unit. The restricted stock units will vest, and the underlying shares will be concurrently issued, in a series of four successive equal quarterly installments over the Reporting Person's period of service as a member of the Issuer's Board of Directors as follows: (i) the first three such quarterly vesting dates shall occur on 08/05/2015, 11/05/2015, 02/05/2016 and (ii) the final quarterly vesting date shall occur upon the Reporting Person's continuation in Board service through the earlier of 05/05/2016 or the day immediately preceding the date of the Broadcom Corporation 2016 Annual Meeting of Shareholders. |
(2) | The securities were awarded in an exempt transaction pursuant to SEC Rule 16b-3(d). |
(3) | Includes (i) 33,819 shares that are held as Class A common stock and (ii) 5,219 shares in the form of restricted stock units that will entitle the Reporting Person to receive one share of Class A common stock per restricted stock unit. |