SEC Form 4 · accession 0001209191-17-019407
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 28, 2017
Accepted (ET)
Mar 8, 2017 · 6:22 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001288469
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common Stock (par value $0.0001)F2 | Feb 28, 2017 | G | 106,850 | $0.00 | D | 106,850 | I | See footnote |
| Class A Common Stock (par value $0.0001)F3 | Feb 28, 2017 | G | 106,850 | $0.00 | A | 106,850 | I | See footnote |
| Class A Common Stock (par value $0.0001)F2 | Feb 28, 2017 | G | 106,850 | $0.00 | D | 0 | I | See footnote |
| Class A Common Stock (par value $0.0001)F5 | Feb 28, 2017 | G | 106,850 | $0.00 | A | 106,850 | I | See footnote |
| Class A Common Stock (par value $0.0001) | holding | — | — | — | 20,845 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents 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.
- F2Shares 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.
- F3Shares 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.
- F4Represents 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.
- F5Shares 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.