| 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
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| OMB APPROVAL |
| OMB Number: |
3235-0287 |
| Expires: |
December 31, 2014 |
| Estimated average burden |
| hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue.
See
Instruction 1(b).
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1. Name and Address of Reporting Person
*
(Street)
|
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, Engineering QTI & CTO |
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3. Date of Earliest Transaction
(Month/Day/Year)
05/05/2019
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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 |
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| Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned |
|---|
| 1.
Title of Security (Instr.
3)
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2.
Transaction Date
(Month/Day/Year) |
2A.
Deemed Execution Date, if any
(Month/Day/Year) |
3.
Transaction 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 |
V |
Amount |
(A) or (D) |
Price |
|
Common Stock
|
05/05/2019 |
|
M |
|
11,357
|
A
|
$
0
|
33,658
|
D
|
|
|
Common Stock
|
05/05/2019 |
|
M |
|
14,963
|
A
|
$
0
|
48,621
|
D
|
|
|
Common Stock
|
05/05/2019 |
|
F |
|
4,585
|
D
|
$
89.29
|
44,036
|
D
|
|
|
Common Stock
|
05/05/2019 |
|
F |
|
7,419
|
D
|
$
89.29
|
36,617
|
D
|
|
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Common Stock
|
05/05/2019 |
|
A |
|
7,331
|
A
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$
0
|
43,948
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D
|
|
|
Common Stock
|
05/05/2019 |
|
F |
|
3,635
|
D
|
$
89.29
|
40,313
|
D
|
|
|
Common Stock
|
|
|
|
|
|
|
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4,539
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I
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Childrens' Trust
|
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Common Stock
|
|
|
|
|
|
|
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45,453
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I
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by Spouse's Trust
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Common Stock
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|
|
|
|
|
|
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45,453
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I
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by Trust
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
|
| Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
|
Restricted Stock Unit
|
|
05/05/2019 |
|
M |
|
|
11,357.555
|
|
05/05/2019
|
Common Stock
|
11,357.555
|
$
0
|
14,963.6388
|
D
|
|
|
Restricted Stock Unit
|
|
05/05/2019 |
|
M |
|
|
14,963.6388
|
|
05/05/2019
|
Common Stock
|
14,963.6388
|
$
0
|
0
|
D
|
|
| Explanation of Responses: |
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By: David Zuckerman, Attorney-in-Fact For: James H. Thompson |
05/06/2019 |
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** 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. |
POWER OF ATTORNEY
I, James H. Thompson, hereby appoint each of David Zuckerman, Michele Shea,
Laura Kreman, and Stephanie Greenwald, of Qualcomm Incorporated
(the "Company"), signing singly, as my attorney-in-fact to:
(1) Obtain Electronic Data Gathering, Analysis, and Retrieval
(EDGAR) Access Codes from the United States Securities and Exchange
Commission (the "SEC");
(2) Execute on my behalf and in my capacity as a director and/or
an officer of the Company, Forms 3, 4 and 5 (the "Form" or "Forms") in
accordance with Section 16(a) of the Securities Exchange Act of 1934, as
amended (the "Act") and the rules thereunder;
(3) Perform any and all acts on my behalf which may be necessary
or desirable to complete and execute any Form and file such Form with the SEC
and any stock exchange or similar authority; and
(4) Take any other action in connection with the foregoing which,
in the opinion of such attorney-in-fact, may be of benefit to, in the best
interest of, or legally required by me, it being understood that the documents
executed by such attorney-in-fact on my behalf pursuant to this Power of
Attorney shall be in such form and shall contain such terms and conditions
as such attorney-in-fact may approve in his or her discretion.
I hereby grant to each such attorney-in-fact full power and authority to do
and perform any act necessary or proper to be done in the exercise of any of
the rights and powers herein granted, as fully to all intents and purposes
as I might or could do if personally present. I ratify and confirm all that
such attorney-in-fact shall lawfully do by the rights and powers granted by
this Power of Attorney. Each attorney-in-fact shall have full power of
substitution or revocation.
I acknowledge that the attorneys-in-fact, in serving in such capacity
at my request, are not assuming, nor is the Company assuming, any of my
responsibilities to comply with Section 16 of the Act.
This Power of Attorney shall remain in full force and effect until
I am no longer required to file the Forms with respect to my holdings of and
transactions in securities issued by the Company, unless I earlier revoke it
in a signed writing delivered to the Stock Administration Department of the
Company for distribution to each of the foregoing attorneys-in-fact, and
supercedes any previous Power of Attorney that may have been signed by me
or on my behalf.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney
to be executed as of this 22nd day of March, 2019.
/s/ James H. Thompson
