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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/20/2013 |
3. Issuer Name and Ticker or Trading Symbol
AFFYMETRIX INC [ AFFX ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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 | 16,412(1) | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Option to Purchase Common Stock | (2) | 11/29/2013 | Common Stock | 4,200 | $24.66 | D | |
Option to Purchase Common Stock | (3) | 06/06/2014 | Common Stock | 600 | $25.71 | D | |
Option to Purchase Common Stock | (4) | 06/23/2015 | Common Stock | 4,200 | $10.29 | D | |
Option to Purchase Common Stock | (5) | 08/21/2015 | Common Stock | 2,000 | $8.71 | D | |
Option to Purchase Common Stock | (6) | 02/19/2016 | Common Stock | 5,000 | $2.97 | D | |
Option to Purchase Common Stock | (7) | 08/20/2016 | Comon Stock | 6,000 | $8.29 | D | |
Option to Purchase Common Stock | (8) | 08/19/2017 | Common Stock | 4,900 | $4.22 | D | |
Option to Purchase Common Stock | (9) | 02/17/2018 | Common Stock | 5,200 | $5.31 | D | |
Option to Purchase Common Stock | (10) | 11/17/2018 | Common Stock | 4,000 | $4.85 | D | |
Option to Purchase Common Stock | (11) | 07/26/2019 | Common Stock | 5,000 | $4.16 | D | |
Option to Purchase Common Stock | (12) | 08/30/2019 | Common Stock | 5,000 | $3.91 | D | |
Option to Purchase Common Stock | (13) | 02/07/2020 | Common Stock | 8,000 | $3.77 | D | |
Option to Purchase Common Stock | (13) | 02/07/2020 | Common Stock | 22,000 | $3.77 | D |
Explanation of Responses: |
1. Includes the following restricted stock units ("RSUs"), each of which vests in equal anual installments over four years from the grant date, less the number of shares withheld for tax purposes on subsequent scheduled vesting date(s) on or before May 20, 2013 ("Shares Withheld"): (1) 1,225 RSUs granted on August 19, 2010 less 289 Shares Withheld, (2) 1,400 RSUs granted on February 17, 2011 less 294 Shares Withheld, (3) 6,000 RSUs granted on November 17, 2011 less 630 Shares Withheld, (4) 1,500 RSUs granted on July 26, 2012, (5) 1,500 RSUs granted on Augst 30, 2012 and (6) 6,000 RSUs granted on February 7, 2013. |
2. Stock option becomes exercisable in equal annual installments over four years from the grant date of November 29, 2006. |
3. Stock option becomes exercisable in equal annual installments over four years from the grant date of June 6, 2007. |
4. Stock option becomes exercisable in equal annual installments over four years from the grant date of June 23, 2008. |
5. Stock option becomes exercisable in equal annual installments over four years from the grant date of August 21, 2008. |
6. Stock option becomes exercisable in equal annual installments over four years from the grant date of February 19, 2009. |
7. Stock option becomes exercisable in equal annual installments over four years from the grant date of August 20, 2009. |
8. Stock option becomes exercisable in equal annual installments over four years from the grant date of August 19, 2010. |
9. Stock option becomes exercisable in equal annual installments over four years from the grant date of February 17, 2011. |
10. Stock option becomes exercisable in equal annual installments over four years from the grant date of November 17, 2011. |
11. Stock option becomes exercisable in equal annual installments over four years from the grant date of July 26, 2012. |
12. Stock option becomes exercisable in equal annual installments over four years from the grant date of August 30, 2012. |
13. Stock option becomes exercisable in equal annual installments over four years from the grant date of February 7, 2013. |
Remarks: |
/s/ Siang H. Chin, Attorney-in-Fact for Gavin Wood | 05/30/2013 | |
** 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. |