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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Options | $ 6.998 | 12/17/2007 | M | 750,000 | 12/12/2007 | 07/22/2012 | Common Stock, par value $0.00001 per share | 750,000 | $ 0 | 0 | I | See footnote (4) | |||
Employee Stock Options | $ 6.998 | 12/17/2007 | M | 600,000 | 12/12/2007 | 07/22/2012 | Common Stock, par value $0.00001 per share | 600,000 | $ 0 | 0 | I | See footnote (4) | |||
Employee Stock Options | $ 6.998 | 12/17/2007 | M | 247,413 | 12/12/2007 | 07/22/2012 | Common Stock, par value $0.00001 per share | 247,413 | $ 0 | 0 | I | See footnote (4) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DOORNINK RONALD C/O ACTIVISION, INC. 3100 OCEAN PARK BOULEVARD SANTA MONICA, CA 90405 |
X |
/s/ Ronald Doornink | 12/19/2007 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Reflects the transfer of restricted stock units from Mr. Doornink to the Ronald Doornink Martha Doornink TTEE U/A/D 12-17-1996 FBO Doornink Rev Living Trust. |
(2) | Represents the previously reported grant of 5,000 restricted stock units, each representing the conditional right to receive one share of Activision common stock, that Mr. Doornink received on October 1, 2007. |
(3) | Includes 177,166 shares of Activision common stock which were erroneously reported on the Form 4 Mr. Doornink filed on October 3, 2007 as being held by him directly but which were then, and are now, actually held indirectly in the name of the Ronald Doornink Martha Doornink TTEE U/A/D 12-17-1996 FBO Doornink Rev Living Trust, and that Form 4 is hereby amended to reflect indirect ownership of such shares. |
(4) | These shares are held by the Ronald Doornink Martha Doornink TTEE U/A/D 12-17-1996 FBO Doornink Rev Living Trust. |
(5) | On December 17, 2007, Mr. Doornink exercised options to purchase 750,000 shares of common stock and, pursuant to the terms of his option award, elected to surrender an aggregate of 447,346 shares to the Company to satisfy the exercise price for such options and the resulting withholding tax obligation. |
(6) | On December 17, 2007, Mr. Doornink exercised options to purchase 600,000 shares of common stock and, pursuant to the terms of his option award, elected to surrender an aggregate of 360,132 shares to the Company to satisfy the exercise price for such options and the resulting withholding tax obligation. |
(7) | On December 17, 2007, Mr. Doornink exercised options to purchase 247,413 shares of common stock and, pursuant to the terms of his option award, elected to surrender an aggregate of 148,501 shares to the Company to satisfy the exercise price for such options and the resulting withholding tax obligation. |
(8) | Following the transactions reported on this Form 4, Mr. Doornink indirectly holds (a) 818,600 shares of Activision common stock and (b) 5,000 restricted stock units representing the conditional right to receive Activision common stock, all of which are held by the Ronald Doornink Martha Doornink TTEE U/A/D 12-17-1996 FBO Doornink Rev Living Trust |