-----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, O5ZAQm/NxDgiQvWz0aihT3W+Jni8UQ3j3Gt8QdwAxZ6r+C8gjebD7pxmoXK7qV5Q 8ij3l1LQ9/zQofMTkFCILQ== 0000950138-05-000123.txt : 20050211 0000950138-05-000123.hdr.sgml : 20050211 20050211185631 ACCESSION NUMBER: 0000950138-05-000123 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050209 FILED AS OF DATE: 20050211 DATE AS OF CHANGE: 20050211 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: KELLY BRIAN G CENTRAL INDEX KEY: 0001091425 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: 05601219 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 feb9kelly-4_ex.xml X0202 4 2005-02-09 0 0000718877 ACTIVISION INC /NY ATVI 0001091425 KELLY BRIAN G C/O ACTIVISION, INC. 3100 OCEAN PARK BOULEVARD SANTA MONICA CA 90405 1 1 0 0 Co-Chairman Common Stock, par value $.000001 per share 2005-02-09 4 M 0 101925 3.8519 A 101925 I See Common Stock, par value $.000001 per share 2005-02-09 4 M 0 33750 3.1289 A 135675 I See Common Stock, par value $.000001 per share 2005-02-09 4 M 0 43272 3.2741 A 178947 I See Common Stock, par value $.000001 per share 2005-02-09 4 M 0 16875 3.1289 A 195822 I See Common Stock, par value $.000001 per share 2005-02-09 4 M 0 1335116 3.1111 A 1530938 I See Common Stock, par value $.000001 per share 2005-02-09 4 M 0 66261 3.0370 A 1597199 I See Common Stock, par value $.000001 per share 2005-02-09 4 M 0 902801 1.8148 A 2500000 I See Common Stock, par value $.000001 per share 2005-02-09 4 S 0 2500000 23.06 D 0 I See Employee Stock Options 3.8519 2005-02-09 4 M 0 101925 0 D 2006-04-01 Common Stock 101925 0 I See Employee Stock Options 3.1289 2005-02-09 4 M 0 33750 0 D 2006-12-20 Common Stock 33750 0 I See Employee Stock Options 3.2741 2005-02-09 4 M 0 43272 0 D 2006-07-17 Common Stock 43272 0 I See Employee Stock Options 3.1289 2005-02-09 4 M 0 16875 0 D 2006-12-20 Common Stock 16875 0 I See Employee Stock Options 3.1111 2005-02-09 4 M 0 1335116 0 D 2009-03-23 Common Stock 1335116 0 I See Employee Stock Options 3.0370 2005-02-09 4 M 0 66261 0 D 2009-04-30 Common Stock 66261 0 I See Employee Stock Options 1.8148 2005-02-09 4 M 0 902801 0 D 2010-05-22 Common Stock 902801 0 I See Represents Common Stock acquired/disposed by Ocean Front LLC, of which the reporting person is a member. Reporting person is the direct beneficial owner of 853,056 shares of Common Stock and an indirect beneficial owner of 63,249 shares of common stock by virtue of his being a member of Delmonte Investments LLC. Represents options to buy Common Stock held by Ocean Front LLC, of which the reporting person is a member. Acquisition/Disposition of shares by Ocean Front LLC, of which the reporting person is a member. Exercise of options to purchase Common Stock by Ocean Front LLC, of which the reporting person is a member. These options were originally issued to the reporting person and subsequently transferred to Ocean Front LLC, and therefore the form of ownership of these options changed from direct to indirect. In accordance with Rule 16a-13, changes in the form of ownership are not required to be reported in a Form 4 or Form 5. The options vested on 4/1/96. The options vested on 12/20/96. The options vested on 4/1/96. The options vested in five equal installments beginning on 3/23/99. The options vested on 4/30/99. The options vested as to 375,000 shares on 5/22/00 and vest as to the remaining 1,125,000 shares in 36 equal monthly installments beginning 6/22/00. George L. Rose was granted a power of attorney to sign all Forms 4 and Forms 5 on behalf of Mr. Kelly. /s/ George L. Rose (as Attorney-In-Fact) 2005-02-11 -----END PRIVACY-ENHANCED MESSAGE-----