-----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, MiWKIWAsRFsqZDkVLp8Kq7wODKOS13dt8eibjqtDBgCOuX8m40TrgGuKBVoZcE8P ADEMs5HuJn2VKWjBJoZmFQ== 0000950138-04-000166.txt : 20040303 0000950138-04-000166.hdr.sgml : 20040303 20040218164139 ACCESSION NUMBER: 0000950138-04-000166 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040210 FILED AS OF DATE: 20040212 DATE AS OF CHANGE: 20040303 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: ROSE GEORGE L CENTRAL INDEX KEY: 0001280548 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15839 FILM NUMBER: 04613641 BUSINESS ADDRESS: STREET 1: C/O BRYAN COVE LLP STREET 2: 1290 AVENUE OF THE AMERICAS CITY: NEW YORK STATE: NY ZIP: 10104-3300 BUSINESS PHONE: 2125412000 MAIL ADDRESS: STREET 1: C/O ACTIVISION INC STREET 2: 3100 OCEAN PARK BLVD CITY: SANTA MONICA STATE: CA ZIP: 90405 4 1 feb11_rose-4ex.xml X0201 4 2004-02-10 0 0000718877 ACTIVISION INC /NY ATVI 0001280548 ROSE GEORGE L C/O ACTIVISION, INC. 3100 OCEAN PARK BOULEVARD SANTA MONICA CA 90405 0 1 0 0 Sr VP & General Counsel Common Stock, par value $.000001 per share 2004-02-10 4 M 0 19600 2.6666 A 19600 D Common Stock, par value $.000001 per share 2004-02-10 4 S 0 19600 20.00 D 0 D Common Stock, par value $.000001 per share 2004-02-10 4 M 0 2900 2.6666 A 2900 D Common Stock, par value $.000001 per share 2004-02-10 4 S 0 2900 20.01 D 0 D Employer Stock Options 2.6666 2004-02-10 4 M 0 22500 0 D 2000-04-18 2010-04-17 Common Stock 22500 0 D The option vested in four equal annual installments beginning on April 18, 2000. /s/ George Rose 2004-02-11 -----END PRIVACY-ENHANCED MESSAGE-----