Statement of Changes in Beneficial Ownership (4)
December 10 2019 - 5:03PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
MODOFF BRIAN |
2. Issuer Name and Ticker or Trading Symbol
QUALCOMM INC/DE
[
QCOM
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) EVP, Strategy and M&A |
(Last)
(First)
(Middle)
5775 MOREHOUSE DR. |
3. Date of Earliest Transaction
(MM/DD/YYYY)
12/8/2019 |
(Street)
SAN DIEGO, CA 92121-1714
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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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)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 12/8/2019 | | A | | 8426 (1) | A | $0.0 | 53089 | I | by Trust (2) |
Common Stock | 12/8/2019 | | F | | 3316 | D | $83.82 | 49773 | I | by Trust (2) |
Common Stock | 12/8/2019 | | A | | 26397 (1) | A | $83.82 | 76170 | I | by Trust (2) |
Common Stock | 12/8/2019 | | F | | 10387 | D | $83.82 | 65783 | I | by Trust (2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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 |
Explanation of Responses: |
(1) | These shares represent Performance Stock Units that vested on October 10, 2019. On December 8, 2019, the HR and Compensation Committee determined and certified the number of shares to be paid. |
(2) | Securities held by Brian Modoff & Terry Modoff TTEES the Modoff Family Rev Trust uad 6/22/01 AMD & RSTD 12/3/2015. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
MODOFF BRIAN 5775 MOREHOUSE DR. SAN DIEGO, CA 92121-1714 |
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| EVP, Strategy and M&A |
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Signatures
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By: David Zuckerman, Attorney-in-Fact For: Brian T. Modoff | | 12/10/2019 |
**Signature of Reporting Person | Date |
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