Specialized Disclosure Report (sd)
May 26 2017 - 04:34PM
Edgar (US Regulatory)
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OMB APPROVAL
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OMB Number:
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3235-0697
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Expires:
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June 30, 2019
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Estimated average burden
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Hours are response:
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480.61
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UNITED STATES
SECURITIES EXCHANGE COMMISSION
Washington, D.C. 20549
FORM SD
Specialized Disclosure Report
Broadcom
Limited
(Exact name of registrant as specified in its charter)
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Singapore
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001-37690
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98-1254807
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(State or other jurisdiction of
incorporation or organization)
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(Commission
File Number)
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(IRS Employer
Identification No.)
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1 Yishun Avenue 7
Singapore 768923
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N/A
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(Address of principal executive offices)
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(Zip code)
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Mark Brazeal, Chief Legal
Officer (408) 433 8000
(Name and telephone number, including area code, of the person to contact in connection with this report.)
Check the appropriate box to indicate the rule pursuant to which this form is being filed, and provide the period to which the information in this form
applies:
☒
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Rule
13p-1
under the Securities Exchange Act (17 CFR
240.13p-1)
for the reporting period from January 1 to December 31, 2016.
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Section 1. Conflict Minerals Disclosure
Item 1.01
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Conflict Minerals Disclosure and Report
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Broadcom Limited (the Company) has evaluated
its product lines for the year ended December 31, 2016 and determined that certain products it manufactures or contracts to have manufactured contain tin, tungsten, tantalum and/or gold. For 2016, the reasonable country of origin inquiry
(RCOI) efforts performed by the Company included conducting a supply chain survey of its direct suppliers to obtain country of origin information for the necessary conflict minerals in our products using the Conflict Minerals Reporting
Template (CMRT).
These supply chain surveys requested that the Companys suppliers identify the smelters and refiners and countries of
origin of the conflict minerals in products they supply to the Company. The Company compared smelters and refiners declared by its suppliers against the list of facilities that are certified conflict free by the Conflict-Free Smelters
Program (CFSP) and obtained countries of origin information (when available) from the Conflict-Free Sourcing Initiative (CFSI). If a smelter or refiner in the Companys supply chain was not listed as having received a
conflict-free designation, it proactively attempted to contact such facility inviting them to commence their participation in an independent third party audit program to demonstrate their compliance with the CFSP assessment protocols.
The Company documented country of origin information for the smelters and refiners identified by the supply chain surveys as provided from multiple sources including the supply chain surveys, independent third party audit programs and directly from
smelters and refiners that it contacted.
There is significant overlap between the Companys RCOI efforts and its due diligence measures performed.
The Companys due diligence measures performed are discussed further in the Conflict Minerals Report filed as Exhibit 1.01 hereto.
Conflict
Minerals Disclosure
A copy of the Companys Conflict Minerals Report is provided as Exhibit 1.01 hereto and is publicly available on its website
at http://www.broadcom.com/corporate_responsibility/environment.php.
The Conflict Minerals Report required by Item 1.01 is filed as Exhibit 1.01 to this
Form.
Section 2. Exhibits
Exhibit 1.01 Conflict Minerals Report, as required by Items 1.01 and 1.02 of
this Form.
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the duly
authorized undersigned.
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BROADCOM LIMITED
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By:
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/s/
Hock E. Tan
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Name:
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Hock E. Tan
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Title:
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President and Chief Executive Officer
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Date: May 26, 2017
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