Initial Statement of Beneficial Ownership (3)
May 30 2013 - 4:47PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
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0.5
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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
*
Wood Gavin
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2. Date of Event Requiring Statement (MM/DD/YYYY)
5/20/2013
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3. Issuer Name
and
Ticker or Trading Symbol
AFFYMETRIX INC [AFFX]
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(Last)
(First)
(Middle)
C/O AFFYMETRIX, INC., 3420 CENTRAL EXPRESSWAY
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
___
X
___ Officer (give title below)
_____ Other (specify below)
Chief Financial Officer /
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(Street)
SANTA CLARA, CA 95051
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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16412
(1)
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Option to Purchase Common Stock
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(2)
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11/29/2013
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Common Stock
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4200
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$24.66
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D
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Option to Purchase Common Stock
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(3)
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6/6/2014
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Common Stock
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600
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$25.71
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D
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Option to Purchase Common Stock
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(4)
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6/23/2015
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Common Stock
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4200
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$10.29
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D
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Option to Purchase Common Stock
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(5)
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8/21/2015
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Common Stock
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2000
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$8.71
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D
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Option to Purchase Common Stock
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(6)
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2/19/2016
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Common Stock
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5000
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$2.97
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D
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Option to Purchase Common Stock
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(7)
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8/20/2016
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Comon Stock
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6000
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$8.29
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D
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Option to Purchase Common Stock
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(8)
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8/19/2017
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Common Stock
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4900
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$4.22
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D
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Option to Purchase Common Stock
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(9)
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2/17/2018
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Common Stock
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5200
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$5.31
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D
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Option to Purchase Common Stock
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(10)
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11/17/2018
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Common Stock
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4000
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$4.85
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D
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Option to Purchase Common Stock
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(11)
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7/26/2019
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Common Stock
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5000
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$4.16
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D
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Option to Purchase Common Stock
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(12)
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8/30/2019
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Common Stock
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5000
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$3.91
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D
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Option to Purchase Common Stock
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(13)
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2/7/2020
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Common Stock
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8000
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$3.77
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D
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Option to Purchase Common Stock
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(13)
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2/7/2020
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Common Stock
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22000
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$3.77
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D
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Explanation of Responses:
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(
1)
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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.
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(
2)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of November 29, 2006.
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(
3)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of June 6, 2007.
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(
4)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of June 23, 2008.
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(
5)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of August 21, 2008.
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(
6)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of February 19, 2009.
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(
7)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of August 20, 2009.
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(
8)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of August 19, 2010.
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(
9)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of February 17, 2011.
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(
10)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of November 17, 2011.
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(
11)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of July 26, 2012.
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(
12)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of August 30, 2012.
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(
13)
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Stock option becomes exercisable in equal annual installments over four years from the grant date of February 7, 2013.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Wood Gavin
C/O AFFYMETRIX, INC.
3420 CENTRAL EXPRESSWAY
SANTA CLARA, CA 95051
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Chief Financial Officer
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Signatures
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/s/ Siang H. Chin, Attorney-in-Fact for Gavin Wood
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5/30/2013
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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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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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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