SEC Form 4 · accession 0001209191-17-014924
MAXLINEAR, INC · MXL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kishore Seendripu
Officer — President and CEO · Director · 10% Owner
Period of report
Feb 23, 2017
Accepted (ET)
Feb 27, 2017 · 5:52 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001288469
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class B Common Stock (convertible into Class A Common Stock)F1,F3 | — | Feb 23, 2017 | G | 1,772,350 | D | — | — | Class A Common Stock ($0.0001 par value) | 1,772,350 | 1,772,351 | I |
| Class B Common Stock (convertible into Class A Common Stock)F1,F4 | — | Feb 23, 2017 | G | 1,772,350 | A | — | — | Class A Common Stock ($0.0001 par value) | 1,772,350 | 1,772,350 | I |
| Class B Common Stock (convertible into Class A Common Stock)F1,F3 | — | Feb 23, 2017 | G | 1,772,351 | D | — | — | Class A Common Stock ($0.0001 par value) | 1,772,351 | 0 | I |
| Class B Common Stock (convertible into Class A Common Stock)F1,F6 | — | Feb 23, 2017 | G | 1,772,351 | A | — | — | Class A Common Stock ($0.0001 par value) | 1,772,351 | 1,772,351 | I |
Explanation of responses
- F1Each share of Class B Common Stock is convertible into one share of Class A Common Stock, which is the publicly traded stock, upon certain transfers and at the option of the holder. On the seventh anniversary of the closing of the Registrant's initial public offering (March 29, 2017), the Class B Common Stock and the Class A Common Stock will automatically convert into a single class of Common Stock.
- F2Represents a transfer of shares for no consideration from the Seendripu Family Trust dated 10/5/09, a trust for the benefit of the Reporting Person and the Reporting Person's spouse, for which the Reporting Person and the Reporting Person's spouse serve as trustees, to the Kishore V. Seendripu 2017 Annuity Trust dated February 17, 2017, a grantor retained annuity trust, for which the Reporting Person serves as trustee.
- F3Shares held by the Seendripu Family Trust dated 10/5/09, a trust for the benefit of the Reporting Person and the Reporting Person's spouse, for which the Reporting Person and the Reporting Person's spouse serve as trustees.
- F4Shares held by the Kishore V. Seendripu 2017 Annuity Trust dated February 17, 2017, a grantor retained annuity trust, for which the Reporting Person serves as trustee.
- F5Represents a transfer of shares for no consideration from the Seendripu Family Trust dated 10/5/09, a trust for the benefit of the Reporting Person and the Reporting Person's spouse, for which the Reporting Person and the Reporting Person's spouse serve as trustees, to the Rekha S. Seendripu 2017 Annuity Trust dated February 17, 2017, a grantor retained annuity trust, for which the Reporting Person serves as trustee.
- F6Shares held by the Rekha S. Seendripu 2017 Annuity Trust dated February 17, 2017, a grantor retained annuity trust, for which the Reporting Person serves as trustee.