0001633978-21-000090.txt : 20211122 0001633978-21-000090.hdr.sgml : 20211122 20211122171927 ACCESSION NUMBER: 0001633978-21-000090 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211119 FILED AS OF DATE: 20211122 DATE AS OF CHANGE: 20211122 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lillie Brian CENTRAL INDEX KEY: 0001648231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36861 FILM NUMBER: 211433649 MAIL ADDRESS: STREET 1: 1485 BROOKMILL ROAD CITY: LOS ALTOS STATE: CA ZIP: 94024 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lumentum Holdings Inc. CENTRAL INDEX KEY: 0001633978 STANDARD INDUSTRIAL CLASSIFICATION: COMMUNICATIONS EQUIPMENT, NEC [3669] IRS NUMBER: 473108385 STATE OF INCORPORATION: DE FISCAL YEAR END: 0702 BUSINESS ADDRESS: STREET 1: 1001 RIDDER PARK DRIVE CITY: SAN JOSE STATE: CA ZIP: 95131 BUSINESS PHONE: 408-546-5483 MAIL ADDRESS: STREET 1: 1001 RIDDER PARK DRIVE CITY: SAN JOSE STATE: CA ZIP: 95131 4 1 wf-form4_163761954458838.xml FORM 4 X0306 4 2021-11-19 0 0001633978 Lumentum Holdings Inc. LITE 0001648231 Lillie Brian C/O LUMENTUM HOLDINGS INC. 1001 RIDDER PARK DRIVE SAN JOSE CA 95131 1 0 0 0 Common Stock 2021-11-19 4 A 0 2618 0 A 14837 D Each share is represented by a restricted stock unit (RSU). Each RSU represents the contingent right to receive, following vesting, one share of Common Stock of the Issuer. 100% of the RSUs shall vest on the earlier of November 19, 2022 or the day prior to the the date of the Issuer's next annual meeting of stockholders, subject to the Reporting Person continuing through such date as a Service Provider, as defined under the Issuer's 2015 Equity Incentive Plan. /s/ Judy G Hamel as Attorney-in-Fact 2021-11-19