FORM 5 |
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 or Section 30(h) of the Investment Company Act of 1940 |
|
|||||||||||||||
![]() |
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. |
1. Name and Address of Reporting Person*
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
Activision Blizzard, Inc. [ ATVI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
||||||||||||||||||||||||
3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2022 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Common Stock, par value $0.000001 per share | 03/04/2022 | G | 20,735(1) | D | $0 | 0(2) | I | By GRATs(3) | |||||||
Common Stock, par value $0.000001 per share | 3,924,881(4)(5) | D | |||||||||||||
Common Stock, par value $0.000001 per share | 1 | I | By ASAC II LLC(6) | ||||||||||||
Common Stock, par value $0.000001 per share | 2 | I | By Delmonte Investments, LLC(7) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. Represents the distribution of shares of Issuer's common stock from a grantor retained annuity trust for benefit of reporting person's children, of which reporting person was the trustee, to the 31427N Trust. |
2. In addition to the distribution referenced in footnote (1), reflects distribution of 16,183 shares of Issuer's common stock to reporting person on 3/4/2022 for estate planning purposes from reporting person's grantor retained annuity trust for benefit of reporting person's children, of which reporting person was the trustee. |
3. Shares were held by grantor retained annuity trust for benefit of reporting person's children, of which reporting person was the trustee. |
4. Includes 16,183 shares received as referenced in footnote (2). |
5. Reporting person no longer has a reportable beneficial interest in 4,800 shares of Issuer's common stock included in reporting person's prior ownership reports as indirectly owned through UTMAs for the benefit of minor children and as to which reporting person disclaimed beneficial ownership except to extent of his pecuniary interest therein. |
6. Reporting person and Brian G. Kelly are managers of ASAC II LLC, and reporting person disclaims beneficial ownership of Issuer's common stock held by ASAC II LLC except to extent of his pecuniary interest therein. |
7. Reflects shares of Issuer's common stock indirectly beneficially owned through Delmonte Investments, LLC, of which reporting person is a member and manager. |
Remarks: |
/s/ Robert A. Kotick | 02/13/2023 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |