SEC Form 4 · accession 0001127602-17-034606
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
Dec 11, 2017
Accepted (ET)
Dec 13, 2017 · 8:40 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 11, 2017 | A | 1,460 | $0.00 | A | 3,669 | 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 11, 2017 | A | 4,379 | A | — | Jan 3, 2021 | Common Stock | 4,379 | 4,379 | D |
Explanation of responses
- F1Grant of restricted stock units shall vest as follows: 25% of the shares subject to the award shall vest on each of November 5, 2018, November 5, 2019, November 5, 2020, and November 5, 2021, subject to awardee's continuing status as 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 January 3, 2021. 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 January 3, 2021, relative to pre-defined objectives, subject to awardee's continuing to be a service provider on such dates.