-----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, GUzvpPZk3jOv2rNnuhJ4Ixe1vHH8kwN0LTJisWPXax2AyauXS6em0atnOhT8dyCx yYfKbT3ma8rub0KGOAEh4g== 0000950138-05-000812.txt : 20050809 0000950138-05-000812.hdr.sgml : 20050809 20050809180731 ACCESSION NUMBER: 0000950138-05-000812 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050805 FILED AS OF DATE: 20050809 DATE AS OF CHANGE: 20050809 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: DOORNINK RONALD CENTRAL INDEX KEY: 0001091428 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: 051011298 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 aug5_doornink-4ex.xml DOCS & PROJECTS/ACTIVIS/2005 FILINGS X0202 4 2005-08-05 0 0000718877 ACTIVISION INC /NY ATVI 0001091428 DOORNINK RONALD C/O ACTIVISION, INC. 3100 OCEAN PARK BLVD SANTA MONICA CA 90405 1 1 0 0 President Common Stock, par value $.000001 per share 2005-08-05 4 M 0 400000 7.6467 A 531135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-05 4 S 0 10000 20.56 D 521135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-05 4 S 0 10000 20.55 D 511135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-05 4 S 0 5000 20.51 D 506135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-05 4 S 0 375000 20.50 D 131135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-08 4 M 0 100000 7.6467 A 231135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-08 4 S 0 50000 20.50 D 181135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-08 4 S 0 20000 20.62 D 161135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-08 4 S 0 15000 20.67 D 146135 I See Footnote 1 Common Stock, par value $.000001 per share 2005-08-08 4 S 0 15000 20.66 D 131135 I See Footnote 1 Employee Stock Options 7.6467 2005-08-05 4 M 0 400000 0 D 2012-07-22 Common Stock 400000 1775000 I See Footnote 1 Employee Stock Options 7.6467 2005-08-05 4 M 0 100000 0 D 2012-07-22 Common Stock 100000 1675000 I See Footnote 1 Employee Stock Options 9.2033 2005-08-08 4 J 0 0 0 D 2012-04-08 Common Stock 180000 180000 I See Footnote 1 Employee Stock Options 4.7234 2005-08-08 4 J 0 0 0 D 2013-02-27 Common Stock 400000 400000 I See Footnote 1 Employee Stock Options 11.2125 2005-08-08 4 J 0 0 0 D 2014-05-03 Common Stock 66667 66667 I See Footnote 1 By the Ronald Doornink Martha Doornink TTEE U/A/D 12-17-1996 FBO Doornink Rev Living Trust. These options vested in three equal annual installments beginning on April 1, 2003. Since the reporting person's last report, these options were transferred to the Ronald Doornink Martha Doornink TTEE U/A/D 12-17-1996 FBO Doornink Rev Living Trust. The options vested in equal installments every six months over a two-year period beginning on October 1, 2002. The options vest in three equal annual installments beginning on April 1, 2004. The options vests in three equal annual installments beginning on May 1, 2005. ***George L. Rose was granted a power of attorney to sign all Forms 4 and Forms 5 on behalf of Ronald Doornink. /s/ George L. Rose*** 2005-08-09 -----END PRIVACY-ENHANCED MESSAGE-----