0001127602-17-019310.txt : 20170524 0001127602-17-019310.hdr.sgml : 20170524 20170524203255 ACCESSION NUMBER: 0001127602-17-019310 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20170522 FILED AS OF DATE: 20170524 DATE AS OF CHANGE: 20170524 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: Van Oene Mark CENTRAL INDEX KEY: 0001707477 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35406 FILM NUMBER: 17868045 MAIL ADDRESS: STREET 1: 5200 ILLUMINA WAY CITY: SAN DIEGO STATE: CA ZIP: 92122 3 1 form3.xml PRIMARY DOCUMENT X0206 3 2017-05-22 0 0001110803 ILLUMINA INC ILMN 0001707477 Van Oene Mark 5200 ILLUMINA WAY SAN DIEGO CA 92122 1 SVP Chief Commercial Officer Common Stock 19056 D Non-qualified Stock Option (Right to Buy) 29.44 2012-01-05 2021-12-05 Common Stock 11838 D Performance Shares 2017-12-31 Common Stock 2212 D Performance Shares 2018-12-30 Common Stock 2752 D Performance Shares 2018-12-30 Common Stock 2887 D Performance Shares 2019-12-29 Common Stock 8210 D Includes 6,694 unvested restricted stock units which vest as follows, subject to awardee's continuing to be a service provider on such dates: 1,926 shares vesting 11/5/17; 787 vesting 1/29/18; 1,925 vesting 11/5/18; 1,372 vesting 11/5/19; 684 vesting 11/5/20. 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. 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 31, 2017. 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 31, 2017, relative to pre-defined objectives, subject to 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 30, 2018. 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 30, 2018, relative to pre-defined objectives, subject to 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 Mark Van Oene 2017-05-24 EX-24 2 doc1.htm POWER OF ATTORNEY Mark Van Oene POA

EXHIBIT 24

Illumina Inc

Power of Attorney
for Executing Forms 3, 4 and 5

Know all men by these presents, that the undersigned, director or officer, or both, of Illumina Inc, hereby constitutes and appoints each of Rebecca Chambers, Scott M. Davies and Robert Maynes, signing singly, the undersigned's true and lawful attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of Illumina Inc (the "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;
(2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4 or 5 and timely file such form with the United States Securities and Exchange Commission and any stock exchange or similar authority; and
(3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities of Illumina Inc unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney as of this 22nd day of May, 2017
/s/ Mark Van Oene
Mark Van Oene