- Initial Statement of Beneficial Ownership (3)
March 07 2012 - 8:02PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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November 30, 2011
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Posard Matthew L.
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2. Date of Event Requiring Statement (MM/DD/YYYY)
2/2/2012
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3. Issuer Name
and
Ticker or Trading Symbol
ILLUMINA INC [ILMN]
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(Last)
(First)
(Middle)
5200 ILLUMINA WAY
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Sr VP & GM, Consumer Genomics /
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(Street)
SAN DIEGO, CA 92122
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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16807.0
(1)
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Non-Qualified Stock Option (right to buy)
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2/25/2007
(2)
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1/25/2017
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Common Stock
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8334.0
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$20.04
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D
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Non-Qualified Stock Option (right to buy)
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2/28/2009
(3)
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1/28/2019
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Common Stock
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17580.0
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$28.45
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D
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Non-Qualified Stock Option (right to buy)
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2/29/2008
(3)
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1/29/2018
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Common Stock
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5032.0
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$32.485
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D
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Non-Qualified Stock Option (right to buy)
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2/27/2010
(3)
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1/27/2020
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Common Stock
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27415.0
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$37.04
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D
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Non-Qualified Stock Option (right to buy)
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2/28/2011
(3)
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1/31/2021
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Common Stock
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36225.0
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$69.34
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D
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Explanation of Responses:
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(
1)
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Includes 8,636 unvested restricted stock units which vest as follows: 1,512 shares vest on 1/27/12; 1,960 shares vest on 1/28/12; 800 shares vest on 1/31/12; 1,764 shares vest on 1/27/13; 1,200 shares vest on 1/31/13; 1,400 shares vest on 1/31/14.
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(
2)
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One -sixtieth (1/60) of the Shares subject to the Option become exercisable on the date indicated above, subject to Optionee's continuing to be a Service Provider on such date. An additional one -sixtieth (1/60) of the Shares subject to the Option shall become exercisable each full month therafter, subject to Optionee's continuing to be a Service Provider on such date.
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(
3)
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One forty-eighth (1/48) of the Shares subject to the Option become exercisable on the date indicated above, subject to Optionee's continuing to be a Service Provider on such date. An additional one-forty eighth (1/48) of the Shares subject to the Option shall become exercisable each full month therafter, subject to Optionee's continuing to be a Service Provider on such date.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Posard Matthew L.
5200 ILLUMINA WAY
SAN DIEGO, CA 92122
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Sr VP & GM, Consumer Genomics
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Signatures
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By: Scott M. Davies For: Matthew L. Posard
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3/7/2012
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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 control number.
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