|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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 |
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 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 (Month/Day/Year) |
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 | ||||||||
Stock Option (Right to Buy) | $ 9.06 | 01/26/2007 | D | 10,000 | (6) | 10/03/2016 | Common Stock | 10,000 | $ 0 | 0 | D | ||||
Stock Option (Right to Buy) | $ 6.2 | 01/26/2007 | D | 20,000 | (7) | 10/21/2015 | Common Stock | 20,000 | $ 0 | 0 | D | ||||
Warrant (Right to Buy) | $ 7.5 | 01/26/2007 | D | 60,577 | (8) | 01/19/2011 | Common Stock | 60,577 | $ 0 | 0 | I | By Amadeus II LP | |||
Warrant (Right to Buy) | $ 7.5 | 01/26/2007 | D | 40,385 | (9) | 01/19/2011 | Common Stock | 40,385 | $ 0 | 0 | I | By Amadeus II B LP | |||
Warrant (Right to Buy) | $ 7.5 | 01/26/2007 | D | 28,269 | (10) | 01/19/2011 | Common Stock | 28,269 | $ 0 | 0 | I | By Amadeus II C LP | |||
Warrant (Right to Buy) | $ 7.5 | 01/26/2007 | D | 1,346 | (11) | 01/19/2011 | Common Stock | 1,346 | $ 0 | 0 | I | By Amadeus II D GmbH and Co KG | |||
Warrant (Right to Buy) | $ 7.5 | 01/26/2007 | D | 4,038 | (12) | 01/19/2011 | Common Stock | 4,038 | $ 0 | 0 | I | By Amadeus II Affiliates LP |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HAUSER HERMANN C/O SOLEXA, INC. 25861 INDUSTRIAL BLVD. HAYWARD, CA 94545 |
X |
/s/ Hermann Hauser, by Kathy San Roman, attorney-in-fact | 01/29/2007 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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) | These shares were surrendered pursuant to a merger agreement between Solexa, Inc. and Illumina, Inc. in exchange for 718,908 shares of Illumina, Inc. common stock. |
(2) | These shares were surrendered pursuant to a merger agreement between Solexa, Inc. and Illumina, Inc. in exchange for 479,272 shares of Illumina, Inc. common stock. |
(3) | These shares were surrendered pursuant to a merger agreement between Solexa, Inc. and Illumina, Inc. in exchange for 335,490 shares of Illumina, Inc. common stock. |
(4) | These shares were surrendered pursuant to a merger agreement between Solexa, Inc. and Illumina, Inc. in exchange for 15,976 shares of Illumina, Inc. common stock. |
(5) | These shares were surrendered pursuant to a merger agreement between Solexa, Inc. and Illumina, Inc. in exchange for 47,926 shares of Illumina, Inc. common stock. |
(6) | This option, which provided for vesting monthly and ratably over the 12 month period beginning on October 21, 2005, was assumed by Illumina, Inc. in connection with the merger with Solexa, Inc. and replaced with an option to purchase 6,880 shares at an exercise price of $18.02 per share. |
(7) | This option, which provided for vesting monthly and ratably over the 12 month period beginning on October 4, 2006, was assumed by Illumina, Inc. in connection with the merger with Solexa, Inc. and replaced with an option to purchase 3,440 shares at an exercise price of $26.34 per share. |
(8) | This warrant, which was exercisable 180 days from January 19, 2006, was assumed by Illumina, Inc. in connection with the merger with Solexa, Inc. and replaced with a warrant to purchase 20,838 shares at an exercise price of $21.80 per share. |
(9) | This warrant, which was exercisable 180 days from January 19, 2006, was assumed by Illumina, Inc. in connection with the merger with Solexa, Inc. and replaced with a warrant to purchase 13,892 shares at an exercise price of $21.80 per share. |
(10) | This warrant, which was exercisable 180 days from January 19, 2006, was assumed by Illumina, Inc. in connection with the merger with Solexa, Inc. and replaced with a warrant to purchase 9,724 shares at an exercise price of $21.80 per share. |
(11) | This warrant, which was exercisable 180 days from January 19, 2006, was assumed by Illumina, Inc. in connection with the merger with Solexa, Inc. and replaced with a warrant to purchase 463 shares at an exercise price of $21.80 per share. |
(12) | This warrant, which was exercisable 180 days from January 19, 2006, was assumed by Illumina, Inc. in connection with the merger with Solexa, Inc. and replaced with a warrant to purchase 1,389 shares at an exercise price of $21.80 per share. |