-----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, OSkCizbJwmZuCQDbnoTsZD8ogZ6Lz/S6mWY2DaPCdLqEpcexwS2E77Q52VG1Vp8W twupEU3xBWTcm03q9dt1Tg== 0000910643-99-000115.txt : 19990723 0000910643-99-000115.hdr.sgml : 19990723 ACCESSION NUMBER: 0000910643-99-000115 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990601 FILED AS OF DATE: 19990722 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ACTIVISION INC /NY CENTRAL INDEX KEY: 0000718877 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 942606438 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-12699 FILM NUMBER: 99668434 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: DEWAR ROBERT J CENTRAL INDEX KEY: 0001091434 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] OFFICER STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 3 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 3 1 FORM 3 U.S. 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, 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* Dewar Robert John - ------------------------------------------- (Last) (First) (Middle) Activision U.K. Gemini House 133 High Street - ------------------------------------------- (Street) Middlesex, West Drayton United Kingdom UB7 7QL - ------------------------------------------- (City) (State) (Zip) 2. Date of Event Re- quiring Statement (Month/Day/Year) 6/1/99 3. IRS or Social Se- curity Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol Activision, Inc. (ATVI) 5. Relationship of Reporting Person to Issuer (Check all applicable) _____ Director _____ 10% Owner X Officer (give _____ Other (specify ----- title below) below) Executive Vice President - International Publishing 6. If Amendment, Date of Original (Month/Day/Year)
Table 1 - Non-Derivative Securities Beneficially Owned 2. Amount of Securities 3. Ownership Form: Direct 4. Nature of Indirect 1. Title of Security Beneficially Owned (D) or Indirect (I) Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 1. Title of Derivative 2. Date Exercisable and 3. Title and Amount of 5. Ownership Security (Instr. 4) Expiration Date Securities Underlying Form of Deri- - ----------------------- (Month/Day/Year) Derivative Security vative Sec- 6. Nature of (Instr. 4) 4. Conversion or urity: Dir- Indirect --------------------- ------------------------ Exercise Price ect (D) or In- Beneficial Date Exer- Expiration Amount or Number of Derivative direct (I) Ownership cisable Date Title of Shares Security (Instr. 5) (Instr. 5) ---------- ---------- ------- ---------------- --------------- -------------- ------------ Employee Stock Options 8/26/99(1) 8/26/06 Common 45,000 $ 9.00 D Stock Employee Stock Options 12/20/96 12/20/06 Common 15,000 $10.56 D Stock Employee Stock Options 4/1/98(2) 4/1/07 Common 6,800 $10.875 D Stock Employee Stock Options 9/1/98(3) 9/2/07 Common 7,500 $13.125 D Stock Employee Stock Options 7/20/98 5/24/08 Common 12,403(4) $ 9.50 D Stock Employee Stock Options 3/24/99(5) 3/24/08 Common 25,000 $ 9.50 D Stock Employee Stock Options 9/14/08 9/14/08 Common 1,000 $10.875 D Stock Employee Stock Options 6/14/99 4/30/09 Common 12,428 $10.25 D Stock Explanation of Responses: (1) The option vests in three equal annual installments beginning on August 26, 1999. (2) The option vested in two equal annual installments beginning on April 1, 1998. (3) The option vests in five equal annual installments beginning on September 1, 1998. (4) The original option for 37,403 was previously exercised with respect to 25,000 shares. (5) The option vests in three equal annual installments beginning on March 24, 1999. ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ Robert John Dewar July 20, 1999 See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). --------------------------- ------------- **Signature of Reporting Person Date 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
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