SEC Form 4 · accession 0001127602-15-033821

ILLUMINA, INC. · ILMN

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Jay T Flatley

Officer — Chief Executive Officer

Period of report

Dec 8, 2015

Accepted (ET)

Dec 10, 2015 · 7:22 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001110803

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1	Dec 8, 2015	A	9,630	$0.00	A	433,423	D
Common Stock^F2	Dec 8, 2015	M	25,000	$27.97	A	458,423	D
Common Stock^F2,F3	Dec 8, 2015	S	6,384	$174.1046	D	452,039	D
Common Stock^F2,F4	Dec 8, 2015	S	2,851	$175.0868	D	449,188	D
Common Stock^F2,F5	Dec 8, 2015	S	463	$176.1943	D	448,725	D
Common Stock^F2,F6	Dec 8, 2015	S	4,068	$177.1334	D	444,657	D
Common Stock^F2,F7	Dec 8, 2015	S	3,270	$178.2802	D	441,387	D
Common Stock^F2,F8	Dec 8, 2015	S	1,764	$179.1966	D	439,623	D
Common Stock^F2,F9	Dec 8, 2015	S	6,200	$179.9947	D	433,423	D
Common Stock	holding	—	—		—	6,000	I	By Daughters

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Performance Shares^F10	—	Dec 8, 2015	A	28,888	A	—	Dec 30, 2018	Common Stock	28,888	28,888	D
Non-qualified Stock Option (Right to Buy)^F2	$27.97	Dec 8, 2015	M	25,000	D	Mar 1, 2009	Jan 29, 2019	Common Stock	25,000	15,000	D

Explanation of responses

F1Grant of restricted stock units that vest as follows: 25% of the shares subject to the award become vested on November 5, 2016, November 5, 2017, November 5, 2018, and November 5, 2019, subject to awardee's continuing to be a service provider on such dates.
F10Each performance stock unit represents a contingent right to receive one share of common stock based on the Company's earnings per share for the fiscal year ending December 30, 2018. The number of shares issued will range from 0% to 150% of the amount specified above, based on the Company's actual earnings per share for the fiscal year ending December 30, 2018, relative to pre-defined objectives, subject to awardee's continuing to be a service provider on such dates.
F2The sale was made pursuant to a 10b5-1 plan.
F3Weighted average sale price representing 6,384 shares sold ranging from $173.56 to $174.53 per share. Number of shares sold at each separate price will be made available to the SEC staff, the issuer, or a security holder of the issuer upon request.
F4Weighted average sale price representing 2,851 shares sold ranging from $174.59 to $175.49 per share. Number of shares sold at each separate price will be made available to the SEC staff, the issuer, or a security holder of the issuer upon request.
F5Weighted average sale price representing 463 shares sold ranging from $175.65 to $176.32 per share. Number of shares sold at each separate price will be made available to the SEC staff, the issuer, or a security holder of the issuer upon request.
F6Weighted average sale price representing 4,068 shares sold ranging from $176.68 to $177.58 per share. Number of shares sold at each separate price will be made available to the SEC staff, the issuer, or a security holder of the issuer upon request.
F7Weighted average sale price representing 3,270 shares sold ranging from $177.75 to $178.73 per share. Number of shares sold at each separate price will be made available to the SEC staff, the issuer, or a security holder of the issuer upon request.
F8Weighted average sale price representing 1,764 shares sold ranging from $178.78 to $179.72 per share. Number of shares sold at each separate price will be made available to the SEC staff, the issuer, or a security holder of the issuer upon request.
F9Weighted average sale price representing 6,200 shares sold ranging from $179.80 to $180.41 per share. Number of shares sold at each separate price will be made available to the SEC staff, the issuer, or a security holder of the issuer upon request.