SEC Form 4 · accession 0001127602-17-007120
ILLUMINA, INC. · ILMN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jay T Flatley
Director
Period of report
Feb 15, 2017
Accepted (ET)
Feb 17, 2017 · 8:37 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 | Feb 15, 2017 | M | 28,510 | $0.00 | A | 527,236 | D | |
| Common StockF2 | Feb 15, 2017 | A | 14,255 | $0.00 | A | 541,491 | D | |
| Common StockF3 | Feb 15, 2017 | F | 22,315 | $163.29 | D | 519,176 | 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 SharesF1 | — | Feb 15, 2017 | M | 28,510 | D | — | Jan 1, 2017 | Common Stock | 28,510 | 0 | D |
Explanation of responses
- F1Represents shares of stock awarded as a result of the Company achieving at least 100% of the applicable performance criteria pursuant to the reporting person's grant of performance share units on Jan. 30, 2014.
- F2Represents additional shares of stock awarded as a result of the Company achieving at least 150% of the applicable performance criteria pursuant to the reporting person's grant of performance share units on Jan. 30, 2014.
- F3Balance includes 273 shares acquired through Employee Stock Purchase Plan.