SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Bouchard Michel

(Last) (First) (Middle)
5200 ILLUMINA WAY

(Street)
SAN DIEGO CA 92122

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2013
3. Issuer Name and Ticker or Trading Symbol
ILLUMINA INC [ ILMN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP, Finance
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 32,288(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Non-Qualified Stock Option (right to buy) 02/28/2009(2) 01/28/2019 Common Stock 1,453 $28.45 D
Non-Qualified Stock Option (right to buy) 02/27/2010(2) 01/27/2020 Common Stock 22,838 $37.04 D
Non-Qualified Stock Option (right to buy) 03/24/2009(3) 03/27/2018 Common Stock 29,875 $37.165 D
Non-Qualified Stock Option (right to buy) 02/28/2011(2) 01/31/2021 Common Stock 30,300 $69.34 D
Explanation of Responses:
1. Includes 20,100 unvested restricted stock units which vest as follows:1,260 shares vesting 1/27/13, 1,355 vesting 1/28/13, 680 vesting 1/31/13, 4,532 vesting 3/8/13, 1,470 vesting 1/27/14, 1,020 vesting 1/31/14, 4,531 vesting 3/8/14, 1,190 vesting 1/31/15, 2,031 vesting 3/8/15, 2,031 vesting 3/8/16; and 12,188 unvested performance stock units, which represent contingent right to receive one share of common stock based on the Company's earnings per share for fiscal year ending 12/28/14 relative to pre-defined objectives.
2. One forty-eighth (1/48) of the Shares subject to the Option become exercisable on the date indicated above, subject to Optionee's continuing to be a Service Provider on such date. An additional one-forty eighth (1/48) of the Shares subject to the Option shall become exercisable each full month therafter, subject to Optionee's continuing to be a Service Provider on such date.
3. One-fourth (1/4) of the shares subject to the option become exercisable on the date indicated above, subject to optionee's continuing to be a service provider on such date. An additional one-forty eighth (1/48) of the shares subject to the option shall become exercisable each full month therafter, subject to optionee's continuing to be a service provider on such date.
By: Scott M. Davies For: Michel Bouchard 01/08/2013
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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