0001127602-17-034606.txt : 20171213 0001127602-17-034606.hdr.sgml : 20171213 20171213204055 ACCESSION NUMBER: 0001127602-17-034606 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171211 FILED AS OF DATE: 20171213 DATE AS OF CHANGE: 20171213 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: 171255029 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 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 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2017-12-11 0001110803 ILLUMINA INC ILMN 0001694295 SAMAD SAMER ABDUL 5200 ILLUMINA WAY SAN DIEGO CA 92122 1 Sr. VP and CFO Common Stock 2017-12-11 4 A 0 1460 0 A 3669 D Performance Shares 2017-12-11 4 A 0 4379 0 A 2021-01-03 Common Stock 4379 4379 D Grant 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. 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 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. By: Robert Maynes for Samer Abdul Samad 2017-12-13