SEC Form 4 · accession 0001127602-16-069357
ILLUMINA, INC. · ILMN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Francis A deSouza
Officer — President and CEO · Director
Period of report
Dec 2, 2016
Accepted (ET)
Dec 6, 2016 · 8:23 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 StockF1 | Dec 2, 2016 | A | 11,728 | $0.00 | A | 119,143 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance SharesF2 | — | Dec 2, 2016 | A | 35,184 | A | — | Dec 29, 2019 | Common Stock | 35,184 | 35,184 | 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, 2017, November 5, 2018, November 5, 2019, and November 5, 2020, subject to awardee's continuing to be a service provider on such dates.
- F2Each 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 29, 2019. 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 29, 2019, relative to pre-defined objectives, subject to awardee's continuing to be a service provider on such dates.