0001127602-22-008120.txt : 20220303 0001127602-22-008120.hdr.sgml : 20220303 20220303184306 ACCESSION NUMBER: 0001127602-22-008120 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220301 FILED AS OF DATE: 20220303 DATE AS OF CHANGE: 20220303 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: 22711129 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 2022-03-01 0001110803 ILLUMINA, INC. ILMN 0001694295 SAMAD SAM 5200 ILLUMINA WAY SAN DIEGO CA 92122 1 SVP and CFO Common Stock 2022-03-01 4 A 0 2082 0 A 11297 D Performance Shares 2022-03-01 4 A 0 6246 0 A 2024-12-29 Common Stock 6246 6246 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, 2022, November 5, 2023, November 5, 2024, and November 5, 2025, subject to the 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 December 29, 2024. The number of shares issued will range from 0% to 200% of the amount specified above, based on the company's actual earnings per share for the fiscal year ending December 29, 2024, relative to pre-defined objectives, subject to the awardee's continuing status as a service provider on such dates. By: Robert Maynes for Sam Samad 2022-03-03