SEC FORM 3

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL 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^*

RAGUSA ROBERT P

(Last)

(First)

(Middle)

5200 ILLUMINA WAY

(Street)

SAN DIEGO

92122

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2019

3. Issuer Name and Ticker or Trading Symbol
ILLUMINA INC [ ILMN ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
	SVP, Global Quality & Ops

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock⁽¹⁾	10,718	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Performance Shares	⁽²⁾	12/30/2018	Common Stock	4,540	⁽²⁾	D
Performance Shares	⁽³⁾	12/29/2019	Common Stock	9,969	⁽³⁾	D
Performance Shares	⁽⁴⁾	01/03/2021	Common Stock	6,306	⁽⁴⁾	D
Performance Shares	⁽⁵⁾	01/02/2022	Common Stock	4,561	⁽⁵⁾	D

Explanation of Responses:

1. Includes 5,137 unvested restricted stock units which vest as follows, subject to awardee's continuing to be a service provider on such dates: 2,117 shares vesting 11/5/19; 1,735 shares vesting 11/5/20; 905 shares vesting 11/5/21; 380 shares vesting 11/5/22.

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 30, 2018. 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 30, 2018, relative to pre-defined objectives, subject to awardee's continuing to be a service provider on such dates.

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, 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.

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 January 3, 2021. 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 January 3, 2021, relative to pre-defined objectives, subject to awardee's continuing to be 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 earnings per share for the fiscal year ending January 2, 2022. 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 January 2, 2022, relative to pre-defined objectives, subject to awardee's continuing to be a service provider on such dates.

	By: Robert Maynes for Robert Ragusa	01/08/2019
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.