| 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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 | | OMB APPROVAL | | OMB Number: | 3235-0287 | | Expires: | February 28, 2011 | | Estimated average burden | | hours per response | 0.5 |
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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*
| C/O AFFYMETRIX, INC., 3420 CENTRAL EXPRESSWAY | |
(Street)
| 2. Issuer Name and Ticker or Trading Symbol
AFFYMETRIX INC
[AFFX] | 5. Relationship of Reporting Person(s) to Issuer
(Check all applicable) | Director | | 10% Owner | | X | Officer (give title below) | | Other (specify below) | | EVP and General Counsel |
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3. Date of Earliest Transaction (Month/Day/Year)
08/20/2009 |
4. If Amendment, Date of Original Filed (Month/Day/Year)
| 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 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 |
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Common Stock
| 08/20/2009 | | A | |
8,000
| A | $
0
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38,000
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D
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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 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 |
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Option to Purchase Common Stock
| $
8.29
| 08/20/2009 | | A | |
35,000
| | | 08/20/2016 |
Common Stock
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35,000
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$
0
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35,000
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D
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| Explanation of Responses: |
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| /s/ John F. Runkel, Jr. | 08/21/2009 |
| ** 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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| 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. |
POWER OF ATTORNEY
Know all persons by these presents, that the
undersigned hereby constitutes and appoints each of
Sandra E. Wells, Vice President and Chief Intellectual
Property Counsel, and Siang H. Chin, Vice President
and Chief Corporate Counsel, as the undersigned's true
and lawful attorney-in-fact to:
(1) execute for and on behalf of the
undersigned, in the undersigned's capacity as a
reporting person pursuant to Section 16 of the
Securities Exchange Act of 1934, as amended (the
"Exchange Act"), and the rules thereunder of
Affymetrix, Inc. (the "Company"), Forms 3, 4 and 5 in
accordance with Section 16(a) of the Exchange Act;
(2) do and perform any and all acts for
and on behalf of the undersigned which may be
necessary or desirable to complete and execute any
such Form 3, 4 or 5 and timely file such form with the
United States Securities and Exchange Commission and
stock exchange or similar authority; and
(3) take any other action of any type
whatsoever in connection with the foregoing which, in
the opinion of any of such attorneys-in-fact, may be
of benefit to, in the best interest of, or legally
required by, the undersigned, it being understood that
the documents executed by any of such attorneys-in-
fact on behalf of the undersigned pursuant to this
Power of Attorney shall be in such form and shall
contain such terms and conditions as any of such
attorneys-in-fact may approve in the discretion of any
of such attorneys-in-fact.
The undersigned hereby grants to each such
attorney-in-fact full power and authority to do and
perform any and every act and thing whatsoever
requisite, necessary, or proper to be done in the
exercise of any of the rights and powers herein
granted, as fully to all intents and purposes as the
undersigned might or could do if personally present,
with full power of substitution or revocation, hereby
ratifying and confirming all that any of such
attorneys-in-fact, or the substitute or substitutes of
any of such attorneys-in-fact, shall lawfully do or
cause to be done by virtue of this Power of Attorney
and the rights and powers herein granted. The
undersigned acknowledges that the foregoing attorneys-
in-fact, in serving in such capacity at the request of
the undersigned, are not assuming, nor is the Company
assuming, any of the undersigned's responsibilities to
comply with Section 16 of the Exchange Act.
This Power of Attorney shall remain in full
force and effect until the undersigned is no longer
required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of and transactions in
securities issued by the Company, unless earlier
revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused
this Power of Attorney to be executed as of this 20th
day of October 2008.
Signature: /s/ John F. (Rick) Runkel
Name: John F. (Rick) Runkel