SEC FORM 4 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*
Silver Lake Group, L.L.C.

(Last) (First) (Middle)
C/O SILVER LAKE
2775 SAND HILL ROAD, SUITE 100

(Street)
MENLO PARK CA 94025

(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)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
04/13/2018
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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(1) 04/13/2018 P 4,976 A $245.5(2) 4,976 I Held through Silver Lake Partners V DE (AIV), L.P.(7)
Common Stock, $0.001 par value(1) 04/13/2018 P 71 A $245.5(2) 71 I Held through Silver Lake Technology Investors V, L.P.(8)
Common Stock, $0.001 par value(1) 04/13/2018 P 47,594 A $246.38(3) 52,570 I Held through Silver Lake Partners V DE (AIV), L.P.(7)
Common Stock, $0.001 par value(1) 04/13/2018 P 681 A $246.38(3) 752 I Held through Silver Lake Technology Investors V, L.P.(8)
Common Stock, $0.001 par value(1) 04/13/2018 P 99,517 A $247.5(4) 152,087 I Held through Silver Lake Partners V DE (AIV), L.P.(7)
Common Stock, $0.001 par value(1) 04/13/2018 P 1,424 A $247.5(4) 2,176 I Held through Silver Lake Technology Investors V, L.P.(8)
Common Stock, $0.001 par value(1) 04/13/2018 P 121,864 A $248.33(5) 273,951 I Held through Silver Lake Partners V DE (AIV), L.P.(7)
Common Stock, $0.001 par value(1) 04/13/2018 P 1,744 A $248.33(5) 3,920 I Held through Silver Lake Technology Investors V, L.P.(8)
Common Stock, $0.001 par value(1) 04/13/2018 P 65,947 A $249.17(6) 339,898 I Held through Silver Lake Partners V DE (AIV), L.P.(7)
Common Stock, $0.001 par value(1) 04/13/2018 P 943 A $249.17(6) 4,863 I Held through Silver Lake Technology Investors V, L.P.(8)
Common Stock, $0.001 par value(1) 1,587,737 I Held through SLP Argo I Ltd.(9)
Common Stock, $0.001 par value(1) 30,830 I Held through SLP Argo II Ltd.((10)
Common Stock, $0.001 par value(1) 76,096 I See footnote(11)
Common Stock, $0.001 par value(1) 9,854 I See footnote(12)
Common Stock, $0.001 par value(1) 18 I See footnote(13)
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
1. Name and Address of Reporting Person*
Silver Lake Group, L.L.C.

(Last) (First) (Middle)
C/O SILVER LAKE
2775 SAND HILL ROAD, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
SLTA V (GP), L.L.C.

(Last) (First) (Middle)
C/O SILVER LAKE
2775 SAND HILL ROAD, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Silver Lake Technology Associates V, L.P.

(Last) (First) (Middle)
C/O SILVER LAKE
2775 SAND HILL ROAD, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Silver Lake Partners V DE (AIV), L.P.

(Last) (First) (Middle)
C/O SILVER LAKE
2775 SAND HILL ROAD, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Silver Lake Technology Investors V, L.P.

(Last) (First) (Middle)
C/O SILVER LAKE
2775 SAND HILL ROAD, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Hao Kenneth

(Last) (First) (Middle)
C/O SILVER LAKE PARTNERS
2775 SAND HILL ROAD, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
Explanation of Responses:
1. This Form 4 is filed on behalf of Silver Lake Partners V DE (AIV), L.P. ("SLP V"), Silver Lake Technology Investors V, L.P. ("SLTI V"), Silver Lake Technology Associates V, L.P. ("SLTA V"), SLTA V (GP), L.L.C. ("SLTA V GP"), Silver Lake Group, L.L.C. ("SLG") and Mr. Kenneth Y. Hao. SLTA V is the general partner of each of SLP V and SLTI V. SLTA V GP is the general partner of SLTA V. SLG is the managing member of SLTA V GP. Mr. Hao, a Managing Director of SLG, serves as a member of the board of directors of Broadcom Inc. (the "Issuer"). Due to Mr. Hao's role at Silver Lake, it is possible that any or all of SLG, SLTA V GP, SLTA V, SLTI V and SLP V may be deemed to be a director by deputization of the Issuer.
2. The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $244.90 to $245.89, inclusive. The reporting persons undertake to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote.
3. The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $245.92 to $246.91, inclusive. The reporting persons undertake to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote.
4. The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $246.92 to $247.91, inclusive. The reporting persons undertake to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote.
5. The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $247.92 to $248.91, inclusive. The reporting persons undertake to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote.
6. The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $248.92 to $249.65, inclusive. The reporting persons undertake to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote.
7. These securities are directly held by SLP V. SLTA V, as the general partner of SLP V, SLTA V GP, as the general partner of SLTA V, and SLG, as the managing member of SLTA V GP may be deemed to have indirect beneficial ownership of these securities. However, pursuant to Rule 16a-1(a)(4) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), this filing shall not be deemed an admission that each of the Reporting Persons are beneficial owners of all securities covered by this filing, and each Reporting Person (except for SLP V) disclaims beneficial ownership of the securities reported herein, except to the extent of such Reporting Person's pecuniary interest therein.
8. These securities are directly held by SLTI V. SLTA V, as the general partner of SLTI V, SLTA V GP, as the general partner of SLTA V, and SLG, as the managing member of SLTA V GP may be deemed to have indirect beneficial ownership of these securities. However, pursuant to Rule 16a-1(a)(4) of the Exchange Act, this filing shall not be deemed an admission that each of the Reporting Persons are beneficial owners of all securities covered by this filing, and each Reporting Person (except for SLTI V) disclaims beneficial ownership of the securities reported herein, except to the extent of such Reporting Person's pecuniary interest therein.
9. These securities are directly held by SLP Argo I Ltd. ("Argo I"). Mr. Hao, as a director of Silver Lake (Offshore) AIV GP IV, Ltd. ("AIV GP IV"), the sole general partner of Silver Lake Technology Associates IV Cayman, L.P. ("SLTA IV Cayman"), the sole general partner of Silver Lake Partners IV Cayman (AIV II), L.P., the sole shareholder of Argo I, may be deemed to be an indirect beneficial owner of the securities directly owned by Argo I.
10. These securities are directly held by SLP Argo II Ltd. ("Argo II"). Mr. Hao, as a director of AIV GP IV, the sole general partner of SLTA IV Cayman, the sole general partner of Silver Lake Technology Investors IV Cayman, L.P., the sole shareholder of Argo II, may be deemed to be an indirect beneficial owner of the securities directly owned by Argo II.
11. These securities are held by Mr. Hao for the benefit of certain entities affiliated with SLG ("Silver Lake"). Pursuant to Mr. Hao's arrangement with Silver Lake with respect to director compensation, upon the sale of these securities, the proceeds from such sale(s) are expected to be remitted to Silver Lake and/or its limited partners. Mr. Hao, through his role at Silver Lake and its affiliates, may be deemed to have an indirect interest in these securities.
12. These securities are held by Hao Family Trust u/a/d 10/12/99.
13. These securities are held by Mr. Hao's family limited partnership.
Remarks:
The Reporting Persons are jointly filing this Form 4 pursuant to Rule 16a-3(j) under the Exchange Act. This filing shall not be deemed an admission that any of the Reporting Persons, other than Mr. Hao, is subject to Section 16 of the Exchange Act, and pursuant to Rule 16a-1(a)(4) of the Exchange Act, this filing shall not be deemed an admission that the Reporting Persons are beneficial owners of all securities covered by this filing, and each Reporting Person disclaims beneficial ownership of these securities, except to the extent of such Reporting Person's pecuniary interest therein, if any.
By: /s/ Karen M. King; Karen M. King, Managing Director and Chief Legal Officer of Silver Lake Group, L.L.C. 04/17/2018
By: /s/ Karen M. King; Karen M. King, Managing Director and Chief Legal Officer of Silver Lake Group, L.L.C., managing member of SLTA V (GP), L.L.C. 04/17/2018
By: /s/ Karen M. King; Karen M. King, Managing Director and Chief Legal Officer of Silver Lake Group L.L.C., managing member of SLTA V (GP) L.L.C., general partner of Silver Lake Technology Associates V, L.P. 04/17/2018
By: /s/ Karen M. King; Karen M. King, Managing Director and Chief Legal Officer of Silver Lake Group, L.L.C., managing member of SLTA V (GP) L.L.C., GP of Silver Lake Technology Associates V, L.P., GP of Silver Lake Partners V DE (AIV), L.P. 04/17/2018
By: /s/ Karen M. King; Karen M. King, Managing Director and Chief Legal Officer of Silver Lake Group, L.L.C., managing member of SLTA V (GP) L.L.C., GP of Silver Lake Technology Associates V, L.P., GP of Silver Lake Technology Investors V, L.P. 04/17/2018
/s/ Kenneth Y. Hao 04/17/2018
** Signature of Reporting Person Date
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