4 1 w47750e4.txt FORM 4 GLAXOSMITHKLINE 1 --------------------------- OMB APPROVAL --------------------------- ------ OMB Number: 3235-0287 FORM 4 Expires: September 30, 1998 ------ Estimated average burden hours per response .... 0.5 --------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP / / Check this box if no longer subject to Filed pursuant to Section 16(a) of the Securities Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the or Form 5 obligations Public Utility Holding Company Act of 1935 may continue. See or Section 30(f) of the Investment Company Instruction 1(b). Act of 1940 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) GlaxoSmithKline plc. (2) Affymetrix, Inc. (AFFX) to Issuer (Check all applicable) --------------------------------------------------------------------------------------------- Director X 10% Owner (Last) (First) (Middle) 3. I.R.S Identification 4. Statement for ---- --- Glaxo Wellcome House Number of Reporting Month/Year Officer (give Other (Specify Berkley Avenue Person, if an entity March 2001 ---- title --- below) --------------------------------------------- (Voluntary) ------------------- below) (Street) ------------------------ 5. If Amendment, 7. Individual or Joint/Group Filing Date of Original (Check Applicable Line) (Month/Year) X Form filed by One Reporting ---- Person Form filed by More than One Greenford, Middlesex, England UB6 0NN ---- Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature (Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In- Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct (Instr. 8) End of Month Direct Benefi- (Month/ (Instr. 3 and 4) (D) or cial Day/ --------------------------------------- Indirect Owner- Year) Code V Amount (A) or Price (I) ship (D) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 10,000 D $56.3750 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 10,000 D $56.0000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 20,000 D $55.8750 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 10,000 D $55.7500 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 5,000 D $55.6250 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 5,000 D $55.5000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 15,000 D $55.1250 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 20,000 D $55.0625 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 30,000 D $55.0000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 5,000 D $54.0000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 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). Potential persons who are to respond to the collection of (Over) information contained in this form are not required to respond Page 1 of 8 Pages unless the form displays a currently valid OMB control number. SEC 1474 (7-97)
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price Security sion or action action Derivative cisable and of Underlying of (Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv- Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative Deriv- Day/ Disposed of (D) (Month/Day/ Secur- ative Year) (Instr. 3, 4, Year) ity Security and 5) (Instr. 5) ----------------------------------- Date Expira- Amount or -------------------------- Exer- tion Title Number of Code V (A) (D) cisable Date Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 9. Number of 10. Ownership 11. Nature of Security Derivative Form of Indirect (Instr. 3) Securities Derivative Beneficial Beneficially Security: Ownership Owned at End Direct (D) (Instr. 4) of Month or Indirect (I) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- Explanation of Responses: **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ 9 Apr 2001 See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ---------------------------- ---------- **Signature of Reporting Person Date By: GlaxoSmithKline plc For: S.M. Bicknell, Company Secretary Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Page 2 Potential persons who are to respond to the collection of information contained in this form are not Page 2 of 8 pages required to respond unless the form displays a currently valid OMB Number. SEC 1474 (7-97)
3 --------------------------- OMB APPROVAL --------------------------- ------ OMB Number: 3235-0287 FORM 4 (continued) Expires: September 30, 1998 ------ Estimated average burden hours per response .... 0.5 --------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP / / Check this box if no longer subject to Filed pursuant to Section 16(a) of the Securities Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the or Form 5 obligations Public Utility Holding Company Act of 1935 may continue. See or Section 30(f) of the Investment Company Instruction 1(b). Act of 1940 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to GlaxoSmithKline plc. Affymetrix, Inc. (AFFX) Issuer (Check all applicable) ------------------------------------------------------------------------------------------ Director 10% Owner (Last) (First) (Middle) 3. I.R.S Identification 4. Statement for ---- --- Glaxo Wellcome House Number of Reporting Month/Year Officer Other Berkeley Avenue Person, if an entity March 2001 ---- (give title --- (specify below) --------------------------------------------- (Voluntary) ------------------- below) (Street) ------------------------ 5. If Amendment, 7. Individual or Joint/Group Filing Date of Original (Check Applicable Line) (Month/Year) Form filed by One Reporting ---- Person Form filed by More than One Greenford, Middlesex, England UB6 0NN ---- Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature (Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In- Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct (Instr. 8) End of Month Direct Benefi- (Month/ (Instr. 3 and 4) (D) or cial Day/ ------------- ------------------------ Indirect Owner- Year) Code V Amount (A) or Price (I) ship (D) (Instr. 4) (Instr. 4) Common Stock 03/01/01 S 5,000 D $53.8750 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 10,000 D $53.7500 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 10,000 D $53.5625 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 5,000 D $53.5000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 10,000 D $53.3750 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/01/01 S 5,000 D $53.2500 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 10,000 D $38.3125 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 5,000 D $38.5000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 10,000 D $38.6250 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 3,000 D $39.1250 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 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). Potential persons who are to respond to the collection of information contained (Over) in this form are not required to respond unless the form displays a currently Page 3 of 8 Pages valid OMB control number. SEC 1474 (7-97)
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price Security sion or action action Derivative cisable and of Underlying of (Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv- Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative Deriv- Day/ Disposed of (D) (Month/Day/ Secur- ative Year) (Instr. 3, 4, Year) ity Security and 5) (Instr. 5) ----------------------------------- Date Expira- Amount or -------- ---------------- Exer- tion Title Number of Code V (A) (D) cisable Date Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 9. Number of 10. Ownership 11. Nature of Security Derivative Form of Indirect (Instr. 3) Securities Derivative Beneficial Beneficially Security: Ownership Owned at End Direct (D) (Instr. 4) of Month or Indirect (I) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- Explanation of Responses: **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ---------------------------- ---------- **Signature of Reporting Person Date Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Page 2 Potential persons who are to respond to the collection of information contained in this form are not Page 6 of 8 pages required to respond unless the form displays a currently valid OMB Number. SEC 1474 (3-99)
5 --------------------------- OMB APPROVAL --------------------------- ------ OMB Number: 3235-0287 FORM 4 (continued) Expires: September 30, 1998 ------ Estimated average burden hours per response .... 0.5 --------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP / / CHECK THIS BOX IF NO LONGER SUBJECT TO Filed pursuant to Section 16(a) of the Securities SECTION 16. FORM 4 Exchange Act of 1934, Section 17(a) of the OR FORM 5 OBLIGATIONS Public Utility Holding Company Act of 1935 MAY CONTINUE. SEE or Section 30(f) of the Investment Company INSTRUCTION 1(b). Act of 1940 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to GlaxoSmithKline plc. Affymetrix, Inc. (AFFX) Issuer (Check all applicable) ------------------------------------------------------------------------------------------ Director 10% Owner (Last) (First) (Middle) 3. I.R.S Identification 4. Statement for ---- --- Glaxo Wellcome House Number of Reporting Month/Year Officer Other Berkley Avenue Person, if an entity March 2001 ---- (give title --- (specify below) --------------------------------------------- (Voluntary) ----------------- below) (Street) ------------------------ 5. If Amendment, 7. Individual or Joint/Group Filing Date of Original (Check Applicable Line) (Month/Year) Form filed by One Reporting ---- Person Form filed by More than One Greenford, Middlesex, England UB6 0NN ---- Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature (Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In- Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct (Instr. 8) End of Month Direct Benefi- (Month/ (Instr. 3 and 4) (D) or cial Day/ --------------------------------------- Indirect Owner- Year) Code V Amount (A) or Price (I) ship (D) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 4,000 D $39.2500 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 2,500 D $39.4375 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 6,350 D $39.7500 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 6,150 D $39.8125 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/20/01 S 3,000 D $40.7500 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/21/01 S 10,000 D $37.0000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/28/01 S 25,000 D $28.5000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/28/01 S 20,000 D $28.6250 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/28/01 S 25,000 D $29.1250 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/28/01 S 20,000 D $29.2500 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ 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). Potential persons who are to respond to the collection of information contained (Over) in this form are not required to respond unless the form displays a currently Page 5 of 8 Pages valid OMB control number. SEC 1474 (7-97)
6 FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price Security sion or action action Derivative cisable and of Underlying of (Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv- Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative Deriv- Day/ Disposed of (D) (Month/Day/ Secur- ative Year) (Instr. 3, 4, Year) ity Security and 5) (Instr. 5) ----------------------------------- Date Expira- Amount or -------------------------- Exer- tion Title Number of Code V (A) (D) cisable Date Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 9. Number of 10. Ownership 11. Nature of Derivative Form of Indirect Securities Derivative Beneficial Beneficially Security: Ownership Owned at End Direct (D) (Instr. 4) of Month or Indirect (I) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- Explanation of Responses: **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ---------------------------- ---------- **Signature of Reporting Person Date Note. File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Page 2 Potential persons who are to respond to the collection of information contained in this form are not Page 4 of 8 pages required to respond unless the form displays a currently valid OMB Number. SEC 1474 (7-97)
7 --------------------------- OMB APPROVAL --------------------------- ------------------ OMB Number: 3235-0287 FORM 4 (continued) Expires: September 30, 1998 ------------------ Estimated average burden hours per response .... 0.5 --------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP / / Check this box if no longer subject to Filed pursuant to Section 16(a) of the Securities Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the or Form 5 obligations Public Utility Holding Company Act of 1935 may continue. See or Section 30(f) of the Investment Company Instruction 1(b). Act of 1940 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) GlaxoSmithKline plc. Affymetrix, Inc. (AFFX) to Issuer (Check all applicable) --------------------------------------------------------------------------------------------- Director 10% Owner (Last) (First) (Middle) 3. I.R.S Identification 4. Statement for ---- --- Glaxo Wellcome House Number of Reporting Month/Year Officer (give Other (specify Berkeley Avenue Person, if an entity March 2001 ---- title --- below) --------------------------------------------- (Voluntary) ------------------- below) (Street) ------------------------ 5. If Amendment, 7. Individual or Joint/Group Filing Date of Original (Check Applicable Line) (Month/Year) Form filed by One Reporting ---- Person Form filed by More than One Greenford, Middlesex, England UB6 0NN ---- Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature (Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In- Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct (Instr. 8) End of Month Direct Benefi- (Month/ (Instr. 3 and 4) (D) or cial Day/ --------------------------------------- Indirect Owner- Year) Code V Amount (A) or Price (I) ship (D) (Instr. 4) (Instr. 4) Common Stock 03/28/01 S 80,000 D $29.0000 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/29/01 S 40,000 D $28.2500 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/29/01 S 20,000 D $28.8750 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/29/01 S 10,000 D $29.8750 I by Corporation ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/29/01 S 10,000 D $29.5000 8,336,224 I by Corporation (2) (1) (2) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 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). Potential persons who are to respond in the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. (Over) Page 7 of 8 pages SEC 1474 (7-97)
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price Security sion or action action Derivative cisable and of Underlying of (Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv- Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative Deriv- Day/ Disposed of (D) (Month/Day/ Secur- ative Year) (Instr. 3, 4, Year) ity Security and 5) (Instr. 5) ----------------------------------- Date Expira- Amount or -------------------------- Exer- tion Title Number of Code V (A) (D) cisable Date Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 9. Number of 10. Ownership 11. Nature of Derivative Form of Indirect Securities Derivative Beneficial Beneficially Security: Ownership Owned at End Direct (D) (Instr. 4) of Month or Indirect (I) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------- Explanation of Responses: **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ---------------------------- ---------- **Signature of Reporting Person Date Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Page 2 Potential persons who are to respond to the collection of information contained in this form are not Page 8 of 8 pages required to respond unless the form displays a currently valid OMB Number. SEC 1474 (7-97)
9 (1) 5,365,214 shares are owned of record by Affymax N.V. All the sales reported on this Form 4 were shares owned of record by Affymax N.V. 269,920 shares are owned of record by Affymax Technologies N.V. 2,514,458 shares are owned of record by GlaxoSmithKline Holdings (Americas) Inc., successor to merger of Glaxo Wellcome Americas Inc. Affymax N.V., Affymax Technologies N.V., GlaxoSmithKline Holdings (Americas) Inc. are indirect subsidiaries of Reporting Person. 79,966 shares are held by Mr. Douglas M. Hurt, formerly a Director of Affymetrix, Inc. designated by the Reporting Person, for the benefit of the Reporting Person. Mr. Hurt disclaims beneficial ownership. Reporting Person beneficially owns such shares. 106,666 shares are held by Dr. Barry C. Ross, formerly a Director of Affymetrix, Inc. designated by the Reporting Person, for the benefit of the Reporting Person. Dr. Ross disclaims beneficial ownership. Reporting Person beneficially owns such shares. (2) All the shares covered by this report are owned beneficially by direct or indirect wholly-owned subsidiaries of GlaxoSmithKline plc. GlaxoSmithKline plc will be the Reporting Person commencing with this Form 4 report and will file a single report with respect to shares held directly and indirectly through its subsidiaries. Previously, each of the subsidiaries referenced in Note (1) had reported under Section 16 with respect to its respective holdings and separate Section 16 reports were filed by Glaxo Venture Limited, Glaxo Group Limited and Glaxo Wellcome plc as shareholders for one or more of those subsidiaries.