Illumina Inc.

10/15/2024 | Press release | Distributed by Public on 10/15/2024 14:59

Initial Statement of Beneficial Ownership - Form 3

Ownership Submission
FORM 3
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 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person *
Davies Scott M
2. Date of Event Requiring Statement (Month/Day/Year)
2024-10-03 		3. Issuer Name and Ticker or Trading Symbol
ILLUMINA, INC. [ILMN]
(Last) (First) (Middle)
5200 ILLUMINA WAY
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
Interim General Counsel /
5. If Amendment, Date Original Filed(Month/Day/Year)
(Street)
SAN DIEGO CA 92122
6. Individual or Join/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 Beneficially Owned
1.Title of Security 2. Amount of Securities Beneficially Owned 3. Ownership Form: Direct (D) or Indirect (I) 4. Nature of Indirect Beneficial Ownership
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security 2. Date Exercisable and Expiration Date 3. Title and Amount of Securities Underlying Derivative Security 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) 6. Nature of Indirect Beneficial Ownership
Date Exercisable Expriation Date Title Amount or Number of Shares

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Davies Scott M
5200 ILLUMINA WAY

SAN DIEGO, CA92122

Interim General Counsel

Signatures

Robert Maynes for Scott M. Davies 2024-10-15
**Signature of Reporting Person Date

Explanation of Responses:

(*) 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) Includes 10,552 unvested Restricted Stock Units granted prior to appointment as Section 16 Officer.
(2) Granted prior to appointment as Section 16 Officer.
(3) 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, 2024. The number of shares issued will range from 0% to 200% of the amount specified above, based on the company's actual earnings per share for the fiscal year ending December 29, 2024, relative to pre-defined objectives, subject to the awardee's continuing status as 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 earnings per share for the fiscal year ending December 29, 2024. 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, 2024, relative to pre-defined objectives, subject to the awardee's continuing status as a service provider on such dates.
(5) 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 December 28, 2025. The number of shares issued will range from 0% to 175% of the amount specified above, based on the company's relative total shareholder return for the fiscal year ending December 28, 2025, relative to pre-defined objectives, subject to the awardee's continuing status as a service provider on such dates.
(6) 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.
(7) 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.
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.