SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
MPM BioVentures Strategic Fund LP

(Last) (First) (Middle)
C/O MPM ASSET MANAGEMENT
200 CLARENDON STREET, 54TH FLOOR

(Street)
BOSTON MA 02116

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AFFYMAX INC [ AFFY ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/19/2006
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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 12/19/2006 X 107,266(5) A $17 138,514 I See Footnote(1)
Common Stock 12/19/2006 F 72,943(2) D $25 65,571 I See Footnote(3)
Common Stock 12/20/2006 C 516,351(9) A $0(7) 581,922 I See Footnote(13)
Common Stock 12/20/2006 C 554,727(10) A $0(8) 1,136,649 I See Footnote(14)
Common Stock 12/20/2006 C 463,820(11) A $0(8) 1,600,469 I See Footnote(15)
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 (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 Securities Underlying Derivative Security (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: 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
Warrant (Right to Buy) $17 12/19/2006 X 107,266 (4) (4) Common Stock 107,266(5) $0 0 I See Footnote(12)
Series B Convertible Preferred Stock (7) 12/20/2006 C 350,000 (6) (6) Common Stock 516,351(9) $0 0 I See Footnote(12)
Series C Convertible Preferred Stock (8) 12/20/2006 C 554,727 (6) (6) Common Stock 554,727(10) $0 0 I See Footnote(12)
Series D Convertible Preferred Stock (8) 12/20/2006 C 463,820 (6) (6) Common Stock 463,820(11) $0 0 I See Footnote(12)
1. Name and Address of Reporting Person*
MPM BioVentures Strategic Fund LP

(Last) (First) (Middle)
C/O MPM ASSET MANAGEMENT
200 CLARENDON STREET, 54TH FLOOR

(Street)
BOSTON MA 02116

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
MPM BIOVENTURES III GP LP

(Last) (First) (Middle)
C/O MPM ASSET MANAGEMENT
200 CLARENDON STREET, 54TH FLOOR

(Street)
BOSTON MA 02116

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
MPM BIOVENTURES III LLC

(Last) (First) (Middle)
C/O MPM ASSET MANAGEMENT
200 CLARENDON STREET, 54TH FLOOR

(Street)
BOSTON MA 02116

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SIMON NICHOLAS J III

(Last) (First) (Middle)
C/O MPM ASSET MANAGEMENT
200 CLARENDON STREET, 54TH FLOOR

(Street)
BOSTON MA 02116

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
HENNER DENNIS

(Last) (First) (Middle)
C/O MPM ASSET MANAGEMENT
200 CLARENDON STREET, 54TH FLOOR

(Street)
BOSTON MA 02116

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The shares are held as follows: 93,388 by MPM BioVentures II-QP, L.P. ("BV II QP"), 10,305 by MPM BioVentures II, L.P. ("BV II"), 1,938 by MPM Asset Management Investors 2001 LLC ("AM 2001") and 32,883 by MPM BioVentures GmbH & Co. Parallel-Beteiligungs KG ("BV KG"). MPM Asset Management II, L.P. ("AM II GP") and MPM Asset Management II LLC ("AM II LLC") are the direct and indirect general partners of BV II QP, BV II and BV KG. Luke Evnin, Ansbert Gadicke, Nicholas Galakatos, Michael Steinmetz and Kurt Wheeler are the members of AM II LLC and AM 2001. Each member of the group disclaims beneficial ownership of the securities except to the extent of its pecuniary interest therein.
2. The shares were net exercised and disposed of as follows: 49,178 by BV II QP, 5,427 BV II, 1,021 AM 2001 and 17,317 by BV KG.
3. The shares are held as follows: 44,210 by BV II QP, 4,878 BV II, 917 AM 2001 and 15,566 by BV KG. Each member of the group disclaims beneficial ownership of the securities except to the extent of its pecuniary interest therein.
4. Immediately exercisable. These warrants shall expire upon the closing of the Issuer's initial public offering.
5. The warrants are held as follows: 72,320 by BV II QP, 7,980 BV II, 1,501 AM 2001 and 25,465 by BV KG.
6. These securities are preferred stock of the Issuer and do not have an expiration date. These securities automatically converted into shares of common stock upon the closing of the Issuer's initial public offering.
7. Each share of Series B Convertible Preferred Stock automatically converted into shares of Common Stock on a 1.47528 for 1 basis immediately prior to the closing of the Issuer's initial public offering.
8. Each share of Series C Convertible Preferred Stock and Series D Convertible Preferred Stock automatically converted into shares of Common Stock on a 1 for 1 basis immediately prior to the closing of the Issuer's initial public offering.
9. The shares are held as follows: 348,125 by BV II QP, 38,416 BV II, 7,228 AM 2001 and 122,582 by BV KG.
10. The shares are held as follows: 373,999 by BV II QP, 41,271 BV II, 7,765 AM 2001 and 131,692 by BV KG.
11. The shares are held as follows: 223,363 by BV II QP, 24,648 BV II, 4,638 AM 2001, 78,651 by BV KG and 132,520 by MPM BioVentures Strategic Fund, L.P. ("MPM SF"). MPM BioVentures III GP, L.P. ("BV III GP") and MPM BioVentures III LLC ("BV III LLC") are the direct and indirect general partners of MPM SF. Luke Evnin, Ansbert Gadicke, Nicholas Galakatos, Michael Steinmetz, Nicholas J. Simon III, Dennis Henner and Kurt Wheeler are members of BV III GP and BV III LLC.
12. No securities owned.
13. The shares are held as follows: 392,335 by BV II QP, 43,294 BV II, 8,145 AM 2001 and 138,148 by BV KG. Each member of the group disclaims beneficial ownership of the securities except to the extent of its pecuniary interest therein.
14. The shares are held as follows: 766,334 by BV II QP, 84,565 BV II, 15,910 AM 2001 and 269,840 by BV KG. Each member of the group disclaims beneficial ownership of the securities except to the extent of its pecuniary interest therein.
15. The shares are held as follows: 989,697 by BV II QP, 109,213 BV II, 20,548 AM 2001, 348,491 by BV KG and 132,520 by MPM SF. Each member of the group disclaims beneficial ownership of the securities except to the extent of its pecuniary interest therein.
Remarks:
See Form 4 for MPM BioVentures II-QP, L.P. for additional filers.
By Luke Evnin Series A Member of MPM BioVentures III, LLC, the general partner of MPM BioVentures III GP, the General Partner of MPM BioVentures Strategic Fund, L.P. /s/ Luke Evnin 12/21/2006
By Luke Evnin, Series A Member of MPM BioVentures III LLC, the general partner of MPM BioVentures III GP, L.P./s/ Luke Evnin 12/21/2006
By Luke Evnin, Series A Member of MPM BioVentures III, LLC /s/ Luke Evnin 12/21/2006
/s/ Nicholas J. Simon III 12/21/2006
/s/ Dennis Henner 12/21/2006
** 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 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).
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