Form 3
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 Symbol
quiring Statement
Henderson Kenneth L. (Month/Day/Year) Activision, Inc. (ATVI)
_____________________________________
(Last) (First) (Middle) July 11, 2001 5. Relationship of Reporting Persons 6. If Amendment,
to Issuer (Check all applicable) Date of Original
c/o Activision, Inc. 3. I.R.S. Identification (Month/Day/Year)
3100 Ocean Park Boulevard Number of Reporing X Director __ 10% Owner
_____________________________________ Person, if an entity 7. Individual or Joint/
(Street) (Voluntary) __ Officer (give __ Other (specify Group Filing (Check
title below) below) Applicable Line)
Santa Monica California 90405 X Form filed by One
_____________________________________ Reporting Person
(City) (State) (Zip) _____________________________ __ Form filed by More
than One Reporting
Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security 2. Amount of Securities 3. Ownership Form: Direct 4. Nature of Indirect Beneficial
(Instr. 4) Beneficially Owned (D) or Indirect (I) Ownership (Instr. 4)
(Instr. 4) (Instr. 5)
None
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v).
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
(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. 5)
Expira- Amount Direct (I)
Date Exer- tion or Number (Instr. 5)
cisable Date Title of Shares
--------- ------- ------------- --------- -------------- -------------- ---------------
None
Explanation of Responses:
** Intentional misstatements or omissions of facts constitute
Federal Criminal Violations. /s/ Kenneth L. Henderson 7/12/01
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). --------------------------- -------------
**Signature of Reporting Person Date
Note: File three copies of this form, one of which must be manually signed. If
space provided is insufficient, See Instruction 6 for procedure. Page 2