5 1 0001.txt FORM 5 FORM 5 [ ] CHECK THIS BOX IF NO LONGER SUBJECT TO SECTION 16. FORM 4 OR FORM 5 OBLIGATIONS MAY CONTINUE. SEE INSTRUCTION 1(b) [ ] FORM 3 HOLDINGS REPORTED [ ] FORM 4 TRANSACTIONS REPORTED OMB APPROVAL -------------------------- OMB Number: 3235-0362 Expires: December 31, 2001 Estimated average burden hours per response.....1.0 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL 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* Tannen Michael ----------------------------------------------------- (Last) (First) (Middle) c/o Tannen Media Ventures 90 Riverside Drive, Suite 5B ----------------------------------------------------- (Street) New York New York 10024 ----------------------------------------------------- (City) (State) (Zip) _______________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Acclaim Entertainment, Inc. (AKLM) _______________________________________________________________________________ 3. IRS or Social Security Number of Reporting Person (Voluntary) XXX-XX-XXXX _______________________________________________________________________________ 4. Statement for Month/Year August 2000 _______________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) _______________________________________________________________________________ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] Officer (give title below) [ ] 10% Owner [ ] Other (specify below) -------------------------------------------------- _______________________________________________________________________________ 7. Individual or Joint/Group filing (Check applicable line) [X] Form filed by one Reporting Person [ ] Form filed by more than one Reporting Person
TABLE I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ------------------------------------------------------------------------------------------------------------------------ 1. 2. 3. 4. 5. 6. 7. --------------------- -------- ---------- ------------------------------ ----------- ---------- ---------- Amount of Securities Owner- Beneficially ship Trans- Trans- Securities Acquired (A) Owned at Form: action action or Disposed of (D) End of Direct Nature of Date Code (Instr. 3, 4 and 5) Issuer's (D) or Indirect Title of (Month/ (Instr. 8) ---------------------------- Fiscal Year Indirect Beneficial Security Day/ ---------- Amount (A) or Price (Instr. (I) Ownership (Instr. 3) Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4) --------------------- -------- ---- ---- ----------- ------ --------- ----------- ---------- ----------
*If the form is filed by more than one reporting person, see Instruction 4(b)(v). (Over) SEC 2270 (3/99) FORM 5 (continued)
TABLE II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ----------------------------------------------------------------------------------------------------------------------------------- 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. ---------- -------- -------- -------- ---------- ------------ -------------- ------ ---------- --------- ---------- Title and Ownership Number of Date Exer- Amount of Form of Derivative cisable and Underlying Number of Deriv- Securities Expiration Securities Price Derivative ative Conver- Trans- Acquired (A) Date (Month/ (Instr. 3 of Securities Security: sion or Trans- action or Disposed Day/Year) and 4) Deriv- Benefi- Direct Exercise action Code of (D) -------------- -------------- ative cially (D) or Nature of Title of Price of Date (Instr. (Instr. 3, Date Amount Secur- Owned at Indirect Indirect Derivative Deriv- (Month/ 8) 4 and 5) Exer- Expir- or Num- ity End of (I) Beneficial Security ative Day/ -------- ---------- cis- ation ber of (Instr. Month (Instr. Ownership (Instr. 3) Security Year) Code V (A) (D) able Date Title Shares 5) (Instr. 4) 4) (Instr. 4) ---------- -------- -------- ---- --- ---- ---- ------- ----- ----- ------ ------ ---------- -------- ---------- Option: Right to Common Buy $1.53125 8/1/00 A(1) 18,750 (1) 7/31/10 Stock 18,750 18,750 D
Explanation of Responses: (1) Such option to acquire 18,750 shares of the Issuer's common stock, par value $.02 per share, was granted to the reporting person under the Issuer's 1998 Stock Incentive Plan. Such option becomes exercisable in one-third installments on each of 8/1/01, 8/1/02 and 8/1/03. /s/ Michael Tannen September 26, 2000 ---------------------------------------- -------------------- ** Signature of Reporting Person Date ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. Page 2