Statement of Changes in Beneficial Ownership (4)
17 Dicembre 2021 - 10:14PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
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Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
| 1. Name
and Address of Reporting Person * Tucker Laurie
Anne |
2. Issuer Name and Ticker or Trading
Symbol ALLIANCE DATA SYSTEMS CORP [ ADS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)__X__
Director _____
10% Owner
_____ Officer (give title
below) _____ Other
(specify below)
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|
(Last)
(First)
(Middle)
3095 LOYALTY CIRCLE |
3. Date of Earliest Transaction (MM/DD/YYYY)
12/15/2021
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|
(Street)
COLUMBUS, OH 43219
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
|
Code |
V |
Amount |
(A) or (D) |
Price |
|
Common Stock |
12/15/2021 |
|
A(1) |
|
227 |
A |
(1) |
16907 (2)(3) |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative
Security |
3. Trans. Date |
3A. Deemed Execution Date, if any |
4. Trans. 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 |
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 of Derivative Security: Direct
(D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr.
4) |
|
Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of
Responses: |
| (1) |
The new grant is for 227
shares of common stock represented by restricted stock units. The
restrictions on 100% of the shares will lapse on the earlier of (i)
12/15/31 or (ii) termination of the director's service on the
Company's board of directors, but in any case not earlier than
December 15, 2022. |
| (2) |
In connection with the
spin-off of Loyalty Ventures Inc. by the Issuer, outstanding
unvested restricted stock units ("RSUs"), including RSUs previously
granted to the Reporting Person, were subject to anti-dilution
adjustments ("Anti-Dilution Adjustment"). To the extent that the
outstanding RSUs granted to the Reporting Person were previously
reported under Table I, the total number of shares reported include
the additional RSUs held by the Reporting Person as a result of the
Anti-Dilution Adjustment. The outstanding RSUs will continue to
vest pursuant to the original vesting schedule for each
grant. |
| (3) |
The total amount of
securities beneficially owned includes: (a) 4,000 unrestricted
shares; (b) 486 unvested restricted stock units granted 6/29/15;
(c) 1,179 unvested restricted stock units granted 6/27/16; (d)
1,085 unvested restricted stock units granted 6/26/17; (e) 1,341
unvested restricted stock units granted 6/25/18; (f) 1,645 unvested
restricted stock units granted 6/24/19; (g) 5,007 unvested
restricted stock units granted 6/22/20; (h) 1,731 unvested
restricted stock units granted 6/15/21; (i) 206 unvested restricted
stock units granted 9/15/21; and (j) the new grant for 227
restricted stock units. |
Reporting
Owners
|
|
Reporting Owner Name / Address |
Relationships
|
|
Director |
10% Owner |
Officer |
Other |
Tucker Laurie Anne
3095 LOYALTY CIRCLE
COLUMBUS, OH 43219 |
X |
|
|
|
Signatures
|
|
Benjamin L. Morgan, Attorney in
Fact |
|
12/17/2021 |
| **Signature of Reporting
Person |
Date |
Grafico Azioni Alliance Data Systems (NYSE:ADS)
Storico
Da Apr 2022 a Mag 2022
Grafico Azioni Alliance Data Systems (NYSE:ADS)
Storico
Da Mag 2021 a Mag 2022
