0001127602-22-006629.txt : 20220224 0001127602-22-006629.hdr.sgml : 20220224 20220224173951 ACCESSION NUMBER: 0001127602-22-006629 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220222 FILED AS OF DATE: 20220224 DATE AS OF CHANGE: 20220224 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SAMAD SAM CENTRAL INDEX KEY: 0001694295 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35406 FILM NUMBER: 22673082 MAIL ADDRESS: STREET 1: 5200 ILLUMINA WAY CITY: SAN DIEGO STATE: CA ZIP: 92122 FORMER NAME: FORMER CONFORMED NAME: SAMAD SAMER ABDUL DATE OF NAME CHANGE: 20170112 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: 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 2022-02-22 0001110803 ILLUMINA, INC. ILMN 0001694295 SAMAD SAM 5200 ILLUMINA WAY SAN DIEGO CA 92122 1 SVP and CFO Common Stock 2022-02-22 4 M 0 4561 0 A 11023 D Common Stock 2022-02-22 4 F 0 1808 319.86 D 9215 D Performance Shares 2022-02-22 4 M 0 4561 0 D 2022-01-02 Common Stock 4561 0 D Represents shares of stock awarded as a result of the Company achieving at least 100% of the applicable performance criteria pursuant to the reporting person's grant of performance share units on December 11, 2018. By: Robert Maynes for Sam Samad 2022-02-24