SEC Form 4 · accession 0001127602-17-001632
ILLUMINA, INC. · ILMN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Samer Abdul Samad
Officer — Sr. VP and CFO
Period of report
Jan 6, 2017
Accepted (ET)
Jan 12, 2017 · 8:36 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 | Jan 6, 2017 | A | 2,209 | $0.00 | A | 2,209 | 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 | — | Jan 6, 2017 | A | 6,626 | A | — | Dec 29, 2019 | Common Stock | 6,626 | 6,626 | D |
Explanation of responses
- F1Grant of restricted stock units with 25% of the shares subject to the award vesting on each of the first, second, third and fourth anniversaries of the date of grant, subject to the 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.