UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Performance Shares | Â (2) | 12/29/2019 | Common Stock | 10,598 | $ (2) | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Hampton Malcolm Garret 5200 ILLUMINA WAY SAN DIEGO, CA 92122 |
 |  |  EVP Clinical Genomics Group |  |
By: Robert Maynes for Malcolm Garret Hampton | 02/17/2017 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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). |
(1) | Grant of restricted stock units that vests as follows: 25% of the shares subject to the award become vested on January 9, 2018, January 9, 2019, January 9, 2020 and January 9, 2021, subject to 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 earnings per share for the fiscal year ending December 29, 2019. The number of shares issued will range from 0% to 150% of the amount specified above, based on the Company's actual earnings per share for the fiscal year ending December 29, 2019, relative to pre-defined objectives, subject to awardee's continuing to be a service provider on such dates. |