FORM 3
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF 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(f) of the Investment Company Act of 1940
1. Name and Address of Reporting Person* 2. Date of Event Re- 4. Issuer Name and Ticker or Trading
quiring Statement Symbol
Pole Michael (Month/Day/Year) Activision, Inc. (ATVI)
(Last) (First) (Middle)
5/15/00 5. Relationship of Reporting Person 6. If Amendment,
c/o Activision, Inc. to Issuer (Check all applicable) Date of Original
3100 Ocean Park Boulevard 3. IRS or Social (Month/Day/Year)
(Street) Security Number of __ Director __ 10% Owner
Reporting Person
(Voluntary) X Officer (give __ Other (specify 7. Individual or Joint/
Santa Monica California 90405 title below) below) Group Filing (check
(City) (State) (Zip) Applicable Line)
Executive Vice President - X Form filed by One
Worldwide Studios Reporting Person
__ Form filed by More
than One Reporting
Person
Table 1 - Non-Derivative Securities Beneficially Owned
2. Amount of Securities 3. Ownership Form: Direct 4. Nature of Indirect Beneficial
1. Title of Security Beneficially Owned (D) or Indirect (I) Ownership (Instr. 5)
(Instr. 4) (Instr. 4) (Instr. 5)
Common Stock, par value $.000001 20,000 D(1)
per share ("Common Stock")
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
(Print or Type Responses)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative 2. Date Exercisable 3. Title and Amount of 4. Conversion or 5. Ownership 6. Nature of
Security (Instr. 4) and Expiration Date Securities Underlying Exercise Price Form of Deri- Indirect
- ----------------------- (Month/Day/Year) Derivative Security of Derivative vative Sec- Beneficial
(Instr. 4) Security urity: Dir- Ownership
--------------------- ---------------------- ect (D) or In (Instr. 4)
Expira- Amount Direct (I)
Date Exer- tion or Number (Instr. 4)
cisable Date Title of Shares
--------- ------- ------------- --------- -------------- -------------- ---------------
Employee Stock Options 5/15/00 4/7/10 Common Stock 50,000 $8.00 D
Employee Stock Options 5/1/01(2) 4/7/10 Common Stock 206,250 $8.00 D
Employee Stock Options 5/1/01(3) 4/12/10 Common Stock 68,750 $6.50 D
Explanation of Responses:
(1) Includes 20,000 shares held by The Pole Family Trust of which the reporting person is a trustee.
(2) The options vest 75,000 shares on 5/1/01; 75,000 shares on 5/1/02; and 56,250 shares on 5/1/03.
(3) The options vest 25,000 shares on 5/1/01; 25,000 shares on 5/1/02; and 18,750 shares on 5/1/03.
* Intentional misstatements or omissions of facts constitute
Federal Criminal Violations. /s/ Michael Pole 08/17/00
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). --------------------------- -------------
**Signature of Reporting Person Date
Michael Pole
Note: File three copies of this form, one of which must be manually signed.
If space provided is insufficient, See Instruction 6 for procedure.
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