Broadcom (AVGO) Form 3 Broadcom / Lake Group, L.L.C. Silver ownership change

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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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. Date of Event Requiring Statement (Month/Day/Year)
04/13/2018

3. Issuer Name and Ticker or Trading Symbol
Broadcom Inc. [ AVGO ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

5. 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 Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
	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)

Explanation of Responses:

Remarks:

This Form 3 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"), and Silver Lake Group, L.L.C. ("SLG"). 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. Kenneth 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 in connection with the purchases of securities being separately reported on a Form 4. The Reporting Persons are jointly filing this Form 3 pursuant to Rule 16a-3(j) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"). This filing shall not be deemed an admission that any of the Reporting Persons is subject to Section 16 of the Exchange Act. Mr. Hao and certain affiliates of the Reporting Persons have separately reported their beneficial ownership of securities of the Issuer (or its predecessor, Broadcom Ltd.) for purposes of Section 16 of the Exchange Act.

No securities are beneficially owned.

	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 IV (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 IV, L.P., GP of Silver Lake Technology Investors V, L.P.	04/17/2018
	** Signature of Reporting Person	Date
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