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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 |
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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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Options (right to buy) | $ 5 | 01/10/2011 | M | 181,165 | (4) | 04/12/2016 | Ordinary Shares | 181,165 | $ 0 | 139,585 | D | ||||
Stock Options (right to buy) | $ 5 | 01/11/2011 | M | 102,407 | (4) | 04/12/2016 | Ordinary Shares | 102,407 | $ 0 | 37,178 | D | ||||
Stock Options (right to buy) | $ 5 | 01/11/2011 | M | 88,076 | (5) | 04/12/2016 | Ordinary Shares | 88,076 | $ 0 | 1,336,924 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
TAN HOCK E C/O AVAGO TECHNOLOGIES LIMITED 350 WEST TRIMBLE ROAD SAN JOSE, CA 95131 |
X | President and CEO |
/s/ Patricia H. McCall, Attorney-in-Fact for Hock E. Tan | 01/11/2011 | |
**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 sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person on September 22, 2010. |
(2) | These transactions were executed in multiple trades in prices ranging from $28.90 to $29.10. The price reported in Column 4 above reflects the weighted average sale price. The Reporting Person hereby undertakes to provide to the Securities and Exchange Commission 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) | These transactions were executed in multiple trades in prices ranging from $29.0023 to $29.0656. The price reported in Column 4 above reflects the weighted average sale price. The Reporting Person hereby undertakes to provide to the Securities and Exchange Commission 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. |
(4) | Option is fully vested and exercisable. |
(5) | After completion of the transaction reported on this Form 4, 766,924 of the shares subject to this option will be fully vested and exercisable, while the remaining 570,000 shares subject thereto will vest in two (2) successive and equal installments on December 1, 2011 and December 1, 2012. |