-----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, Mp6d37POvA//Rskt/7hL3rYG0+o/inydj/ZE0faw5abem/5jVCxU8++b/bI+2+ie RJ9eCu+EpxV4G+bZycOejQ== 0000950138-05-000924.txt : 20050919 0000950138-05-000924.hdr.sgml : 20050919 20050919161052 ACCESSION NUMBER: 0000950138-05-000924 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050915 FILED AS OF DATE: 20050919 DATE AS OF CHANGE: 20050919 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: KOTICK ROBERT A CENTRAL INDEX KEY: 0001091423 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: 051091526 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 sept19_kotick-4ex.xml ACTIVIS\2005\SEPT 19 KOTICK-4 X0202 4 2005-09-15 0 0000718877 ACTIVISION INC /NY ATVI 0001091423 KOTICK ROBERT A C/O ACTIVISON, INC. 3100 OCEAN PARK BOULEVARD SANTA MONICA CA 90405 1 1 0 0 Chairman & Chief Exec Officer Common Stock, par value $.000001 per share 2005-09-15 4 S 0 500000 22.1008 D 3397246 I See footnote. Disposition of shares by The Robert A. Kotick Trust, in which the reporting person has a pecuniary interest. Reporting Person is the direct beneficial owner of 3,312,914 shares of Common Stock and is an indirect beneficial owner of 84,332 shares of Common Stock by virtue of being a member of Delmonte Investments L.L.C. ***George L. Rose was granted a power of attorney to sign all Forms 4 and Forms 5 on behalf of Robert Kotick. /s/ George L. Rose (as Attorney-In-Fact)*** 2005-09-19 -----END PRIVACY-ENHANCED MESSAGE-----