-----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, AzyZM3VnQUTQzSjlKx71dRx82bMiqAowrGZY1S7/6zxTMkMriY5OnFxCrcfOntaG 027xhGGYMKYi0dbv7CfkIQ== 0000950138-04-000011.txt : 20040107 0000950138-04-000011.hdr.sgml : 20040107 20040107161637 ACCESSION NUMBER: 0000950138-04-000011 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040105 FILED AS OF DATE: 20040107 ISSUER: 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 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GOLDBERG LAWRENCE CENTRAL INDEX KEY: 0001091427 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15839 FILM NUMBER: 04513324 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 jan6goldberg-4_ex.xml ACTIVIS\2004\JAN 6 GOLDBERG-4 X0201 4 2004-01-05 1 0000718877 ACTIVISION INC /NY ATVI 0001091427 GOLDBERG LAWRENCE 3100 OCEAN PARK BLVD STE 1000 SANTA MONICA CA 90405 0 0 0 1 Former Ex VP-Worldwide Studios Common Stock, par value $.000001 per share 2004-01-05 4 M 0 9750 4.6944 A 12265 D Common Stock, par value $.000001 per share 2004-01-05 4 S 0 9750 18.90 D 2515 D Common Stock, par value $.000001 per share 2004-01-05 4 M 0 14450 2.6667 A 16965 D Common Stock, par value $.000001 per share 2004-01-05 4 S 0 14450 18.90 D 2515 D Common Stock, par value $.000001 per share 2004-01-05 4 M 0 300 2.6667 A 2815 D Common Stock, par value $.000001 per share 2004-01-05 4 S 0 300 18.901 D 2515 D Common Stock, par value $.000001 per share 2004-01-05 4 M 0 2000 2.6667 A 4515 D Common Stock, par value $.000001 per share 2004-01-05 4 S 0 2000 18.91 D 2515 D Employee Stock Options 2.6667 2004-01-05 4 M 0 16750 0 D 2000-04-18 2010-04-17 Common Stock 16750 0 D Employee Stock Options 4.6944 2004-01-05 4 M 0 9750 0 D 2000-03-04 2009-03-03 Common Stock 9750 0 D One fifth of the option vested on April 18, 2000. The rest of the option vested in three equal annual installments beginning on March 31, 2001. The option vested in three equal annual installments beginning on March 4, 2000. /s/ Lawrence Goldberg 2004-01-06 -----END PRIVACY-ENHANCED MESSAGE-----