-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Chumyf4z7ISWAjdGztIdHRb1LeSAtJ2l6Z7KtkS89KHkLRDbrXrbxhxFntFEzFvJ SngYjqyhKcEPciqTxBnXeA== 0000910643-01-500051.txt : 20010612 0000910643-01-500051.hdr.sgml : 20010612 ACCESSION NUMBER: 0000910643-01-500051 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010531 FILED AS OF DATE: 20010611 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ACTIVISION INC /NY CENTRAL INDEX KEY: 0000718877 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 954803544 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-15839 FILM NUMBER: 1658209 BUSINESS ADDRESS: STREET 1: 3100 OCEAN PARK BLVD STREET 2: STE 1000 CITY: SANTA MONICA STATE: CA ZIP: 90405 BUSINESS PHONE: 3102552000 MAIL ADDRESS: STREET 1: 11601 WILSHIRE BLVD 3RD FL STREET 2: STE 1000 CITY: LOS ANGELES STATE: CA ZIP: 90025 FORMER COMPANY: FORMER CONFORMED NAME: MEDIAGENIC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: ACTIVISION INC DATE OF NAME CHANGE: 19880829 COMPANY DATA: COMPANY CONFORMED NAME: DOORNINK RONALD CENTRAL INDEX KEY: 0001091428 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] OFFICER STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 3100 OCEAN PARK BLVD STREET 2: STE 1000 CITY: SANTA MONICA STATE: CA ZIP: 90405 BUSINESS PHONE: 3102552000 MAIL ADDRESS: STREET 1: 3100 OCEAN PARK BLVD CITY: SANTA MONICA STATE: CA ZIP: 90405 4 1 file001.htm ACTIVIS/JUNE FORM4-DOORNINK/FILE001.HTM Form 4


                                               U.S. SECURITIES AND EXCHANGE COMMISSION
                                                       Washington, D.C. 20549

                                                               FORM 4

                                            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(f) of the Investment Company Act of 1940

1. Name and Address of Reporting Person*    2. Issuer Name and Ticker or Trading Symbol       6. Relationship of Reporting Person
   Doornink       Ronald                       Activision, Inc. (ATVI)                           to Issuer (Check all applicable)
__________________________________________  _____________________________________________     ___ Director      ___ 10% Owner
                                                                                              _X_ Officer (give ___ Other (Specify
  (Last)          (First)         (Middle)  3. IRS or Social Security 4. Statement for            title below)      below)
  c/o Activision, Inc.                         Number of Reporting       Month/Year
  3100 Ocean Park Boulevard                    Person (Voluntary)        May 2001             President and Chief Operating Officer
__________________________________________                            ______________________________________________________________
                 (Street)
                                                                    5. If Amendment, Date of  7. Individual or Joint/Group Filing
  Santa Monica    California       90405                               Original (Month/Year)     (Check Applicable Line)
__________________________________________                                                    _X_ Form Filed by One Reporting Person
  (City)          (State)          (Zip)                                                      ___ Form Filed by More Than One
                                                                                                  Reporting Person


                                            Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

                                                                                     5. Amount of
                                          3. Trans-    4.  Securities Acquired (A)      Securities
                              2. Trans-      action        or Disposed of (D)           Beneficially  6. Ownership
                                 action      Code          (Instr. 3, 4 and 5)          Owned at         Form:         7. Nature of
                                 Date        (Instr.   ---------------------------      End of           Direct(D)        Indirect
                                (Month/        8)                  (A)                  Month               or            Beneficial
1.  Title of Security            Day/                  Amount      or     Price        (Instr.          Indirect(I)      Ownership
    (Instr.3)                    Year)                             (D)                  3 and 4)         (Instr. 4)      (Instr. 4)
- ----------------------------- ---------   ----------   --------    ---    --------   ------------     -------------    ------------
Common Stock, par value
     $.000001 per share         5/22/01        M        18,750      A       $6.00
Common Stock, par value
     $.000001 per share         5/22/01        S        18,750      D      $30.1037
Common Stock, par value
     $.000001 per share         5/22/01        M        33,334      A      $10.56
Common Stock, par value
     $.000001 per share         5/22/01        S        33,334      D      $30.1037
Common Stock, par value
     $.000001 per share         5/22/01        M        31,706      A      $10.25
Common Stock, par value
     $.000001 per share         5/22/01        S        31,706      D      $30.1037
Common Stock, par value
     $.000001 per share         5/25/01        M        52,371      A      $20.875
Common Stock, par value
     $.000001 per share         5/25/01        S        52,371      D      $33.1578     10,000                D



* If the form is filed by more than one Reporting Person, see Instruction 4(b)(v).
Reminder:  Report on a separate line for each class of securities beneficially owned directly or indirectly.


                                                             Page 1 of 2


                   Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
                                   (e.g., puts, calls, warrants, options, convertible securities)

                                       2. Conver-                              5. Number of Deriv-        6. Date Exercisable
                                          sion or    3. Trans-   4. Trans-        ative Securities           and Expiration Date
                                          Exercise      action      action        Acquired (A) or            (Month/Day/Year)
                                          Price of      Date        Code          Disposed of (D)         -----------------------
                                          Deriv-        (Month/    (Instr. 8)     (Instr. 3, 4, and 5)    Date
1. Title of Derivative Security           ative         Day/     -----   ----  -----------------------    Exercis-     Expiration
   (Instr. 3)                             Security      Year)     Code     V         (A)        (D)        able         Date
- ----------------------------------     -----------   ----------  ------------  ----------- -----------    ----------   ----------
Employee Stock Options                     $6.00       5/22/01     M                         18,750       10/1/00(1)    4/18/10
Employee Stock Options                    $10.56       5/22/01     M                         33,334       4/1/00(2)     4/30/09
Employee Stock Options                    $10.25       5/22/01     M                         31,706       6/11/99       4/30/99
Employee Stock Options                    $20.875      5/25/01     M                         52,371       5/3/01        4/4/11
Employee Stock Options                    $20.875      4/4/01      A       V      52,371                  5/3/01        4/4/11


                                                                          9. Number of    10. Ownership
                                                                             Derivative       Form of
                                                                             Securities       Derivative
                        7. Title and Amount of Underlying                    Benefi-          Security:
                           Securities (Instr. 3 and 4)                       cially           Direct       11. Nature of
                        ---------------------------------  8. Price of       Owned            (D) or           Indirect
                                                Amount or     Derivative     at End           Indirect         Beneficial
1. Title of Derivative          Title           Number of     Security       of Month         (I)              Ownership
   Security (Instr. 3)                          Shares        (Instr. 5)     (Instr. 4)       (Instr. 4)       (Instr. 4)
- ----------------------  --------------------    ---------  -------------  -------------   --------------   --------------
Employee Stock Options      Common Stock        18,750          $6.00
Employee Stock Options      Common Stock        33,334         $10.56
Employee Stock Options      Common Stock        31,706         $10.25
Employee Stock Options      Common Stock        52,371         $20.875
Employee Stock Options      Common Stock        52,371         $20.875         604,166          D



Explanation of Responses

(1)  The options vest in four equal installments of 18,750 shares on each of
     October 1, 2000; April 1, 2001; October 1, 2001; and April 1, 2002.
(2)  The options vest in three equal annual installments beginning on April 1, 2000.


                                                                                /s/ Ronald Doornink                  6/7/01
**Intentional misstatements or omissions of facts constitute                    -------------------------------   ----------
  Federal Criminal Violations.  See 18 U.S.C. 1001 and                          **Signature of Reporting Person      Date
  15 U.S.C. 78ff(a).

Note:  File three copies of this Form, one of which must be manually signed.
       If space provided is insufficient, see Instruction 6 for procedure.

                                                             Page 2 of 2
-----END PRIVACY-ENHANCED MESSAGE-----