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*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol Broadcom Ltd [ AVGO ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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| 3. Date of Earliest Transaction (Month/Day/Year) 03/13/2017 | ||||||||||||||||||||||||||
| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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| 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 | ||||||
| Ordinary Shares, no par value | 03/13/2017 | M | 717 | A | $48.18 | 32,455(1) | D | |||
| Ordinary Shares, no par value | 03/13/2017 | M | 1,650 | A | $38.92 | 34,105(1) | D | |||
| Ordinary Shares, no par value | 03/13/2017 | M | 1,502 | A | $62.63 | 35,607(1) | D | |||
| Ordinary Shares, no par value | 03/13/2017 | M | 15,000 | A | $71.86 | 50,607(1) | D | |||
| Ordinary Shares, no par value | 03/13/2017 | S | 21,272 | D | $225.972(2) | 29,335(1) | D | |||
| Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 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 | ||||||||
| Stock Option (Right to Buy) | $48.18 | 03/13/2017 | M | 717 | (3) | 03/01/2019 | Ordinary Shares, no par value | 717 | $0 | 0 | D | ||||
| Stock Option (Right to Buy) | $38.92 | 03/13/2017 | M | 1,650 | (3) | 03/01/2020 | Ordinary Shares, no par value | 1,650 | $0 | 0 | D | ||||
| Stock Option (Right to Buy) | $62.63 | 03/13/2017 | M | 1,502 | (4) | 03/01/2021 | Ordinary Shares, no par value | 1,502 | $0 | 750 | D | ||||
| Stock Option (Right to Buy) | $71.86 | 03/13/2017 | M | 15,000 | (5) | 06/09/2021 | Ordinary Shares, no par value | 15,000 | $0 | 15,000 | D | ||||
| Explanation of Responses: |
| 1. Includes 29,274 Restricted Share Units. |
| 2. Transaction executed in multiple trades at prices ranging from $225.78 to $226.32 per share, inclusive. The price reported in column 4 above reflects the weighted average sale price per share. The Reporting Person hereby undertakes to provide the SEC staff, the Issuer or a security holder of the Issuer, upon request, full information regarding the number of shares sold at each respective price within the range set forth in this footnote. |
| 3. The option is fully vested and exercisable. |
| 4. Option to purchase ordinary shares of the Company, granted pursuant to the LSI Corporation 2003 Equity Incentive Plan, assumed by the Company upon the closing of its acquisition of LSI on May 6, 2014 (the "LSI Plan"). The option vests over 4 years, with one-fourth vesting on March 1 of each of 2015, 2016, 2017, 2018, subject to the Reporting Person's continuing service on each vesting date. |
| 5. Share price performance option (the "2014 Option") granted pursuant to the Avago Plan. The 2014 Option vests over four years, with 25% vesting on each anniversary of the date of grant, such that the 2014 Option will be fully vested on June 10, 2018. The exercisability requirements for the 2014 Option have been met. |
| Remarks: |
| /s/ Patricia McCall, Attorney-in-Fact for Kirsten M Spears | 03/14/2017 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * 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). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| 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 Number. | ||