SEC Form 3
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*
Koczynski Chester

(Last) (First) (Middle)
ONE FRANKLIN PLAZA
200 NORTH 16TH ST

(Street)
PHILADELPHIA PA 19102

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/30/2012
3. Issuer Name and Ticker or Trading Symbol
HUMAN GENOME SCIENCES INC [ HGSI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. 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
Table I - Non-Derivative Securities Beneficially Owned
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)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Explanation of Responses:
Remarks:
On July 30, 2012, the Reporting Person was appointed as a director of Human Genome Sciences, Inc. (the "Issuer") by GlaxoSmithKline plc ("GSK"), which at that time beneficially owned approximately 79%, or 158,660,878, of the outstanding shares of the Issuer (the "Shares") through its wholly owned subsidiary H. Acquisition Corp. ("HAC"). Pursuant to the Terms of the Agreement and Plan of Merger, dated as of July 16, 2012, by and among GSK, HAC and the Issuer, on August 2, 2012, HAC exercised its top-up option and, as the owner of more than 90% of the Shares, subsequently completed a short form merger with the Issuer. The Reporting Person disclaims any beneficial ownership (as defined in Rule 16a-1(a) under the Securities Exchange Act of 1934, as amended) in the Shares. No securities are beneficially owned.
No securities are beneficially owned.
/s/ Chester Koczynski, Director, Human Genome Sciences, Inc. 08/09/2012
** 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.
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