-----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, GJDCEfV+nYw8TOR2wSYIY6bJ5PiUguqpVNvMmsNH0FaA9XNM+uIIKaRUnGS+66Oo dgEAEiB5RgsfveJtkY/bSw== 0000950138-04-000171.txt : 20040219 0000950138-04-000171.hdr.sgml : 20040219 20040219164637 ACCESSION NUMBER: 0000950138-04-000171 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040217 FILED AS OF DATE: 20040219 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: 04616605 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 feb19_goldberg-4ex.xml ACTIVIS\2004\FEB FORM 4S\FEB 19 GOLDBERG-4 X0201 4 2004-02-17 1 0000718877 ACTIVISION INC /NY ATVI 0001091427 GOLDBERG LAWRENCE C/O ACTIVISION, INC. 3100 OCEAN PARK BOULEVARD SANTA MONICA CA 90405 0 0 0 1 Former Ex VP-Worldwide Studios Common Stock, par value $.000001 per share 2004-02-17 4 M 0 12000 9.2778 A 14515 D Common Stock, par value $.000001 per share 2004-02-17 4 S 0 12000 21 D 2515 D Common Stock, par value $.000001 per share 2004-02-17 4 M 0 1120 4.8333 A 3635 D Common Stock, par value $.000001 per share 2004-02-17 4 S 0 1120 21 D 2515 D Common Stock, par value $.000001 per share 2004-02-17 4 M 0 1230 11.1111 A 3745 D Common Stock, par value $.000001 per share 2004-02-17 4 S 0 1230 21 D 2515 D Employee Stock Options 9.2778 2004-02-17 4 M 0 12000 0 D 2001-10-01 2004-08-01 Common Stock 12000 0 D Employee Stock Options 4.8333 2004-02-17 4 M 0 1120 0 D 1998-04-01 2004-08-01 Common Stock 1120 0 D Employee Stock Options 11.1111 2004-02-17 4 M 0 1230 0 D 2001-10-01 2004-07-01 Common Stock 1230 0 D One quarter of the option vested on each of October 1, 2001 and April 1, 2002. The remaining one-half of the option vested on May 7, 2002. The option vested in two equal installments beginning on April 1, 1998. George L. Rose was granted a power of attorney to sign all Forms 4 and Forms 5 on behalf of Lawrence Goldberg. /s/ George L. Rose (Attorney-In-Fact) 2004-02-19 -----END PRIVACY-ENHANCED MESSAGE-----