Sec Form 4 Filing - Thaysen Jacob @ ILLUMINA, INC. - 2024-03-05

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, 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
Thaysen Jacob
2. Issuer Name and Ticker or Trading Symbol
ILLUMINA, INC. [ ILMN]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Executive Officer
(Last) (First) (Middle)
5200 ILLUMINA WAY
3. Date of Earliest Transaction (MM/DD/YY)
03/05/2024
(Street)
SAN DIEGO, CA92122
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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 03/05/2024 A 22,276 ( 1 ) A $ 0 37,137 D
Common Stock 03/05/2024 A 7,426 ( 2 ) A $ 0 44,563 D
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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 ( 3 ) 03/05/2024 A 25,988 ( 3 ) 01/03/2027 Common Stock 25,988 $ 0 25,988 D
Performance Shares ( 4 ) 03/05/2024 A 25,988 ( 4 ) 01/03/2027 Common Stock 25,988 $ 0 25,988 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Thaysen Jacob
5200 ILLUMINA WAY
SAN DIEGO, CA92122
X Chief Executive Officer
Signatures
By: Robert Maynes for Jacob Thaysen 03/06/2024
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Grant of restricted stock units shall vest as follows: 25% of the shares subject to the award shall vest on each of February 15, 2025, February 15, 2026, February 15, 2027, and February 15, 2028, subject to awardee's continuing status as a service provider on such dates.
( 2 )Grant of restricted stock units shall vest as follows: 100% of the shares subject to the award shall vest on March 5, 2027, subject to awardee's continuing status as a service provider on such date as well as holding of the contingent purchased shares.
( 3 )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.
( 4 )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.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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