SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
BORI CARLOS S

(Last) (First) (Middle)
5260 CALIFORNIA AVENUE

(Street)
IRVINE CA 92617

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
SKYWORKS SOLUTIONS, INC. [ SWKS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, Sales & Marketing
3. Date of Earliest Transaction (Month/Day/Year)
11/05/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 11/05/2021 A 8,204(1) A $0.00 22,491 D
Common Stock 11/05/2021 F 4,068(2) D $164.06 18,423 D
Common Stock 11/05/2021 M 2,735 A (3) 21,158 D
Common Stock 11/05/2021 F 1,357(2) D $164.06 19,801 D
Common Stock 11/05/2021 M 7,597 A (3) 27,398 D
Common Stock 11/05/2021 F 3,767(2) D $164.06 23,631 D
Common Stock 11/08/2021 A 7,266(4) A $0.00 30,897 D
Common Stock 11/08/2021 F 3,603(2) D $167.77 27,294 D
Common Stock 11/08/2021 M 3,267 A (3) 30,561 D
Common Stock 11/08/2021 F 1,620(2) D $167.77 28,941 D
Common Stock 11/08/2021 M 2,158 A (3) 31,099 D
Common Stock 11/08/2021 F 1,070(2) D $167.77 30,029 D
Common Stock 1,371(5) I By 401(k) plan
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 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: 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
Restricted Stock Units (3) 11/05/2021 M 2,735 (6) (6) Common Stock 2,735 $0.00 5,470 D
Restricted Stock Units (3) 11/05/2021 M 7,597 (7) (7) Common Stock 7,597 $0.00 0 D
Restricted Stock Units (3) 11/08/2021 M 3,267 (8) (8) Common Stock 3,267 $0.00 3,267 D
Restricted Stock Units (3) 11/08/2021 M 2,158 (9) (9) Common Stock 2,158 $0.00 0 D
Explanation of Responses:
1. Represents 8,204 shares of common stock issued to the Reporting Person pursuant to a performance share award dated 11/5/2019. Such performance share award contained both a continued employment condition and a performance condition related to the achievement by the Issuer of certain pre-established performance metrics for fiscal year 2020.
2. Represents shares withheld to satisfy tax withholding obligations related to the issuance of unrestricted stock to the Reporting Person.
3. Restricted stock units convert into shares of common stock on a one-for-one basis.
4. Represents 7,266 shares of common stock issued to the Reporting Person pursuant to a performance share award dated 11/6/2018. Such performance share award contained both a continued employment condition and a performance condition related to the achievement by the Issuer of certain pre-established performance metrics for the performance period consisting of fiscal years 2019, 2020, and 2021.
5. This total represents the number of shares of common stock held by the Reporting Person in the Skyworks Solutions, Inc. 401(k) plan based on the latest plan statement dated 10/31/2021.
6. The restricted stock units vest in four (4) equal installments, beginning on 11/5/2020 and ending on 11/5/2023.
7. The restricted stock units vested in two (2) equal installments, beginning on 11/5/2020 and ending on 11/5/2021.
8. The restricted stock units vest in four (4) equal installments, beginning on 11/6/2019 and ending on 11/6/2022.
9. The restricted stock units vested in four (4) equal installments, beginning on 11/7/2018 and ending on 11/7/2021.
Remarks:
Daniel L. Ricks, as Attorney-In-Fact for Carlos S. Bori 11/09/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.