SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
1. Name and Address of Reporting Person*
Cunningham Everett

(Last) (First) (Middle)
5200 ILLUMINA WAY

(Street)
SAN DIEGO CA 92122

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ILLUMINA, INC. [ ILMN ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, Chief Commercial Officer
3. Date of Earliest Transaction (Month/Day/Year)
07/05/2024
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 07/05/2024 A 36,860(1) A $0 36,860 D
Common Stock 70 I Beneficiary IRA
Common Stock 757 I IRA
Common Stock 3,151 I Revocable Trust
Common Stock 672 I Spouse IRA
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Performance Shares (2) 07/05/2024 A 18,430 (2) 01/03/2027 Common Stock 18,430 $0 18,430 D
Performance Shares (3) 07/05/2024 A 18,430 (3) 01/03/2027 Common Stock 18,430 $0 18,430 D
Explanation of Responses:
1. Grant of restricted stock units with 25% of the shares subject to the award vesting on each of the first, second, third and fourth anniversaries of the date of grant, subject to the awardee's continuing to be a service provider on such dates.
2. Each performance stock unit represents a contingent right to receive one share of common stock based on the Company's three-year average operating margin for fiscal years 2024-2026 with vesting on January 3, 2027 . The number of shares issued will range from 0% to 200% of the amount specified above, based on the Company's actual three-year average operating margin for fiscal years 2024-2026 , relative to pre-defined objectives, subject to awardee's continuing to be a service provider on such dates.
3. Each performance stock unit represents a contingent right to receive one share of common stock based on the Company's relative total shareholder return for the fiscal year ending January 3, 2027. The number of shares issued will range from 0% to 200% of the amount specified above, based on the company's relative total shareholder return for the fiscal year ending January 3, 2027, relative to pre-defined objectives, subject to the awardee's continuing status as a service provider on such dates.
Robert Maynes for Everett Cunningham 07/09/2024
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.