0001127602-17-001632.txt : 20170112 0001127602-17-001632.hdr.sgml : 20170112 20170112203634 ACCESSION NUMBER: 0001127602-17-001632 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170106 FILED AS OF DATE: 20170112 DATE AS OF CHANGE: 20170112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ILLUMINA INC CENTRAL INDEX KEY: 0001110803 STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826] IRS NUMBER: 330804655 STATE OF INCORPORATION: DE FISCAL YEAR END: 0101 BUSINESS ADDRESS: STREET 1: 5200 ILLUMINA WAY CITY: SAN DIEGO STATE: CA ZIP: 92122 BUSINESS PHONE: 8582024500 MAIL ADDRESS: STREET 1: 5200 ILLUMINA WAY CITY: SAN DIEGO STATE: CA ZIP: 92122 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SAMAD SAMER ABDUL CENTRAL INDEX KEY: 0001694295 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35406 FILM NUMBER: 17526225 MAIL ADDRESS: STREET 1: 5200 ILLUMINA WAY CITY: SAN DIEGO STATE: CA ZIP: 92122 FORMER NAME: FORMER CONFORMED NAME: SAMAD SAMER ABDUL Baranowski DATE OF NAME CHANGE: 20170111 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2017-01-06 0001110803 ILLUMINA INC ILMN 0001694295 SAMAD SAMER ABDUL 5200 ILLUMINA WAY SAN DIEGO CA 92122 1 Sr. VP and CFO Common Stock 2017-01-06 4 A 0 2209 0 A 2209 D Performance Shares 2017-01-06 4 A 0 6626 0 A 2019-12-29 Common Stock 6626 6626 D Grant 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. Each 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. By: Robert Maynes for Samer Abdul Samad 2017-01-12