0001179110-12-014181.txt : 20120917 0001179110-12-014181.hdr.sgml : 20120917 20120917211225 ACCESSION NUMBER: 0001179110-12-014181 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120913 FILED AS OF DATE: 20120917 DATE AS OF CHANGE: 20120917 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Orwin John A CENTRAL INDEX KEY: 0001477384 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33213 FILM NUMBER: 121096021 MAIL ADDRESS: STREET 1: C/O NEUROGESX INC STREET 2: 2215 BRIDGEPOINTE PARKWAY SUITE 200 CITY: SAN MATEO STATE: CA ZIP: 94040 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AFFYMAX INC CENTRAL INDEX KEY: 0001158223 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4001 MIRANDA AVE CITY: PALO ALTO STATE: CA ZIP: 94304 BUSINESS PHONE: 650-812-8700 MAIL ADDRESS: STREET 1: 4001 MIRANDA AVE. CITY: PALO ALTO STATE: CA ZIP: 94304 4 1 edgar.xml FORM 4 - X0306 4 2012-09-13 0 0001158223 AFFYMAX INC AFFY 0001477384 Orwin John A C/O AFFYMAX, INC. 4001 MIRANDA AVE. PALO ALTO CA 94304 1 1 0 0 CEO Common Stock 2012-09-13 4 M 0 37497 6.90 A 129497 D Common Stock 2012-09-13 4 M 0 11500 5.83 A 140997 D Common Stock 2012-09-13 4 S 0 48997 20.00 D 92000 D Stock Option (Right to Buy) 5.83 2012-09-13 4 M 0 11500 0.00 D 2020-09-21 Common Stock 11500 45500 D Stock Option (Right to Buy) 6.90 2012-09-13 4 M 0 37497 0.00 D 2021-01-31 Common Stock 37497 225007 D The shares reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan. The shares vest and become exercisable in a series of forty-eight (48) successive equal monthly installments over the four (4) year period measured from September 22, 2010. The shares vest and become exercisable in a series of forty-eight (48) successive equal monthly installments over the four (4) year period measured from February 1, 2011. /s/ Grace U. Shin, Attorney-in-fact 2012-09-17