0001127602-21-028745.txt : 20211109
0001127602-21-028745.hdr.sgml : 20211109
20211109185254
ACCESSION NUMBER: 0001127602-21-028745
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211105
FILED AS OF DATE: 20211109
DATE AS OF CHANGE: 20211109
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Pegels Kevin Carl
CENTRAL INDEX KEY: 0001892104
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35406
FILM NUMBER: 211393719
MAIL ADDRESS:
STREET 1: 5200 ILLUMINA WAY
CITY: SAN DIEGO
STATE: CA
ZIP: 92122
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: 0102
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
FORMER COMPANY:
FORMER CONFORMED NAME: ILLUMINA INC
DATE OF NAME CHANGE: 20000331
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2021-11-05
0001110803
ILLUMINA, INC.
ILMN
0001892104
Pegels Kevin Carl
5200 ILLUMINA WAY
SAN DIEGO
CA
92122
1
Chief of Global Operations
Common Stock
2021-11-05
4
F
0
574
408.14
D
4845
D
Performance Shares
2021-11-05
4
A
0
1226
0
A
2023-12-31
Common Stock
1226
1226
D
Includes unvested Restricted Stock Units granted prior to appointment as Section 16 Officer.
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, 2023. The number of shares issued will range from 0% to 175% of the amount specified above, based on the Company's actual earnings per share for the fiscal year ending December 31,2023, relative to pre-defined objectives, subject to awardee's continuing to be a service provider on such dates.
By: Robert Maynes for Kevin Pegels
2021-11-09