Henderson - Form 4
FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
[ ]Check this box if no longer subject to
Section 16. Form 4 or Form 5
obligations may continue. See
Instruction 1(b) 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(h) of the Investment Company Act of 1940
(Print or Type Responses)
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting
Person(s) to Issuer (Check all
Henderson Kenneth L. Activision, Inc. (ATVI) Applicable)
__________________________________________ _____________________________________________ _X_ Director ___ 10% Owner
(Last) (First) (Middle) 3. IRS Identification 4. Statement for ___ Officer (give ___ Other (specify
Number of Reporting Month/Day/Year title below) below)
c/o Bryan Cave LLP Person, if an entity
1290 Avenue of the Americas (voluntary) September 19, 2002
__________________________________________ _________________________________________________________________
(Street) 5. If Amendment, Date 7. Individual or Joint/Group Filing
of Original (Check Applicable Line)
New York NY 10104 (Month/Day/Year) _X_ Form filed by One Reporting Person
__________________________________________ ___ Form filed by More than One
(City) (State) (Zip) Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
2A. 5. Amount of
Deemed 3. Trans- 4. Securities Acquired (A) Securities
2. Trans- Exe- action or Disposed of (D) Beneficially
action cution Code (Instr. 3, 4 and 5) Owned 6. Ownership
Date Date, (Instr. ----------------------- Following Form: 7. Nature of
(Month/ if any 8) (A) Reported Direct Indirect
1. Title of Security Day/ (Month/ ---------- Amount or Price Trans- (D) or Beneficial
(Instr.3) Year) Day/Year) Code V (D) action(s) Indirect(I) Ownership
----------------------------- --------- --------- ------ ---- -------- --- -------- ------------ ----------- ----------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
* If the form is filed by more than one reporting person, see Instruction 4(b)(v). SEC 1474 (9-02)
Persons who respond to the collection of information contained
in this form are not required to respond unless the form displays
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FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
6. Date
Exercisable
and
Expiration
2. Conver- 3A. Deemed 5. Number of Deriv- Date
sion or 3. Trans- Execution 4. Trans- ative Securities (Month/
Exercise action Date, if action Acquired (A) or Day/Year)
Price of Date any Code Disposed of (D) ---------------
Deriv- (Month/ (Month/ (Instr. 8) (Instr. 3, 4, and 5) Date Expir-
1. Title of Derivative Security ative Day/ Day/ ----- ----- ----------------------- Exer- ation
(Instr. 3) Security Year) Year) Code V A D cisable Date
-------------------------------- ----------- ---------- ------------- ------ ----- ----------- ----------- -------- ------
Director Stock Options $25.36 9/19/02 -- A 12,500 3/19/03(1) 9/18/12
9. Number of
Derivative 10. Ownership
Securities Form of
Beneficially Derivative
7. Title and Amount of Underlying Owned Security
Securities (Instr. 3 and 4) Following Direct 11. Nature of
--------------------------------- 8. Price of Reported (D) or Indirect
Amount or Derivative Trans- Indirect Beneficial
1. Title of Derivative Title Number of Security action(s) (I) Ownership
Security (Instr. 3) Shares (Instr. 5) (Instr. 4) (Instr. 4) (Instr. 4)
---------------------- -------------------- --------- ------------- ------------- -------------- --------------
Director Stock Options Common Stock 12,500 $25.36 12,500 D
Explanation of Responses
(1) The options vest in four equal semi-annual installments beginning on March 19, 2003.
/s/Kenneth L. Henderson 9/20/02
**Intentional misstatements or omissions of facts constitute -------------------------------------- ----------
Federal Criminal Violations. See 18 U.S.C. 1001 and **Signature of Reporting Person Date
15 U.S.C. 78ff(a). Kenneth L. Henderson
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
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