EX-99.A1D 6 mar0502_ex-a1d.txt EXHIBIT (a)(1)(D) Options Summary Affymetrix, Inc. Page [1] ID: [___________] File: Optsum 3380 Central Expressway Date: [__/__/02] Santa Clara, CA 95051 Time: [____] As of: [__/__/02] $ [ ] --- [Option Holder Name] ID: [Option Holder ID Number] [Address]
Option No.: [______] Option Date: [__/__/__] Shares: [_________] Price: $[_____] Plan: [_____] Type: [_____]
VESTING SCHEDULE TRANSACTIONS CANCELLATIONS Granted Full Vest Exercisable Total Price Expires Date Type Shares Value Date Reason Shares -------- --------- ----------- ----------- ------- ---- ----- ------ ----- ---- ------- ------
Total Options Exercisable: [___________] Total Price: $[___________] Total Potential Gain: $[___________]