-----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, D2WWGk5c1ivZy9eVIn7U2LFLt7NrNUITM95ZzsxeNaytncsLiVGuRFmO1Z/G7tWR 3jpoh+VeNpAVWN9AjGG6Hw== 0000910643-00-000073.txt : 20000502 0000910643-00-000073.hdr.sgml : 20000502 ACCESSION NUMBER: 0000910643-00-000073 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000430 FILED AS OF DATE: 20000501 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: 4 SEC ACT: SEC FILE NUMBER: 001-15839 FILM NUMBER: 614529 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: KELLY BRIAN G CENTRAL INDEX KEY: 0001091425 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] DIRECTOR STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4 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
FORM 4 [ ] Check this box if no longer U.S. SECURITIES AND EXCHANGE COMMISSION subject to Section 16. Form Washington, D.C. 20549 4 or Form 5 obligations may continue. See Instruction 1(b). STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to Issuer (Check all applicable) Kelly Brian G. Activision, Inc. (ATVI) _X_ Director ___ 10% Owner __________________________________________ _____________________________________________ _X_ Officer (give ___ Other (Specify (Last) (First) (Middle) 3. IRS or Social 4. Statement for title below) below) Security Number of Month/Year Reporting Person c/o Activision, Inc. (Voluntary) April, 2000 Co-Chairman 3100 Ocean Park Boulevard ______________________________________________________________ __________________________________________ (Street) 5. If Amendment, Date of 7. Individual or Joint/Group Filing Original (Month/Year) (Check Applicable Line) Santa Monica CA 90405 _X_ Form Filed by One Reporting Person __________________________________________ ___ Form Filed by More Than One (City) (State) (Zip) Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 5. Amount of 3. Trans- 4. Securities Acquired (A) Securities 2. Trans- action or Disposed of (D) Beneficially 6. Ownership action Code (Instr. 3, 4 and 5) Owned at Form: 7. Nature of Date (Instr. --------------------------- End of Direct(D) Indirect (Month/ 8) (A) Month or Beneficial 1. Title of Security Day/ Amount or Price (Instr. Indirect(I) Ownership (Instr.3) Year) (D) 3 and 4) (Instr. 4) (Instr. 4) - ----------------------------- --------- ---------- -------- --- -------- ------------ ------------- ------------ Common Stock, par value $.000001 per share 4/18/00 G 7,032 D 186,091 D Common Stock, par value $.000001 per share 4/18/00 G 7,032 A 44,513 I (1) * If this form is filed by more than one Reporting Person, see Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 2. Conver- 5. Number of Deriv- 6. Date Exercisable sion or 3. Trans- 4. Trans- ative Securities and Expiration Date Exercise action action Acquired (A) or (Month/Day/Year) Price of Date Code Disposed of (D) ----------------------- Deriv- (Month/ (Instr. 8) (Instr. 3, 4, and 5) Date 1. Title of Derivative Security ative Day/ ----- ---- ----------------------- Exercis- Expiration (Instr. 3) Security Year) Code V (A) (D) able Date - ---------------------------------- ----------- ---------- ------------ ----------- ----------- ---------- ---------- 9. Number of 10. Ownership Derivative Form of Securities Derivative 7. Title and Amount of Underlying Benefi- Security: Securities (Instr. 3 and 4) cially Direct 11. Nature of --------------------------------- 8. Price of Owned (D) or Indirect Amount or Derivative at End Indirect Beneficial 1. Title of Derivative Title Number of Security of Month (I) Ownership Security (Instr. 3) Shares (Instr. 5) (Instr. 4) (Instr. 4) (Instr. 4) - ---------------------- -------------------- --------- ------------- ------------- -------------- -------------- Explanation of Responses (1) Includes 7,032 shares of Common Stock transferred by the reporting person to an irrevocable trust for the benefit of reporting person's minor children. The reporting person does not exercise or share investment control over such shares. Also includes 37,481 shares held by Delmonte Investments LLC, of which the reporting person is a member. The reporting person disclaims beneficial ownership of these shares, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such shares for purposes of Section 16 or for any other purpose. /s/ Brian G. Kelly 4/26/00 **Intentional misstatements or omissions of facts constitute ------------------------------- ---------- Federal Criminal Violations. See 18 U.S.C. 1001 and **Signature of Reporting Person Date 15 U.S.C. 78ff(a). Brian G. Kelly 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 SEC 1474 (8-92)
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