| FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 |
OMB APPROVAL | ||||||||||||||||||||||
| STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP | ||||||||||||||||||||||||
| o Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
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 |
OMB Number: 3235-0287 Expires: December 31, 2001 Estimated average burden hours per response. . . . . 0.5 |
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| 1. Name and Address of Reporting Person* | 2. | Issuer Name and Ticker | 4. | Statement for | 6. | Relationship of Reporting Person(s) to Issuer | ||||||||||||||||||
| or Trading Symbol | (Month/Year) | (Check all applicable) | ||||||||||||||||||||||
| Parks, J. Michael | Alliance Data Systems Corporation ADS | September 2001 | ___X___
Director ______ 10% Owner ___X___ Officer ______ Other |
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| (Last) | (First) | (Middle) | Officer/Other Description Chairman of the Board, Chief Executive Officer | |||||||||||||||||||||
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17655 Waterview Parkway |
3. | I.R.S. Identification Number of Reporting Person, if an entity (voluntary) | 5. | If Amendment, Date of Original (Month/Year) |
7. | Individual or Joint/Group Filing (Check Applicable Line) |
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Chairman of the Board, Chief Executive Officer | X Form
filed by One Reporting Person Form filed by More than One Reporting Person |
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| (Street) | ||||||||||||||||||||||||
| Dallas, TX 75252-8012 | ||||||||||||||||||||||||
| (City) | (State) | (Zip) | ||||||||||||||||||||||
| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||||||||||||||||
| 1. | Title of Security (Instr. 3) |
2. | Transaction Date (Month/Day/Year) |
3. | Transaction Code and Voluntary Code (Instr. 8) |
4. | Securities Acquired (A) or Disposed of (D) Of (Instr. 3, 4 and 5) |
5. | Amount of Securities Beneficially Owned at End
of Month (Instr. 3 and 4) |
6. | Ownership Form: Direct (D) or Indirect (I) (Instr. 4) |
7. | Nature of Indirect Beneficial Ownership (Instr. 4) |
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| Code | V | Amount | A/ D | Price | |||||||||||||||||||||||
| Common | 9/25/2001 | J | | 3,500(1) | A | $14.00 | 124,500 (2) | D | |||||||||||||||||||
| 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). | ||||||||||||||||||||||||
| Table II - Derivative
Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) |
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| 1. | Title
of Derivative Security (Instr. 3) |
2. | Conversion
or Exercise Price of Deivative Security |
3. | Transaction Date (Month/Day/ Year) |
4. | Transaction
Code and Voluntary (V) Code (Instr. 8) |
5. | Number
of Derivative Securities Acquired (A) or isposed (D) Of (Instr. 3, 4 and 5) |
6. | Date
Exercisable(DE) and Expiration Date(ED) (Month/Day/Year) |
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| Code | V | (A) | (D) | Date Exercisable |
Expiration Date |
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| Employee Stock Option (right to buy) | $9.00 | Varies (3) (4) (5) 03/09/2007 | |||||||||||||
| Employee Stock Option (right to buy) | $9.90 | Varies (6) 05/06/2009 | |||||||||||||
| Employee Stock Option (right to buy) | $15.00 | Varies (7) 08/31/2010 | |||||||||||||
| Employee Stock Option (right to buy) | $12.00 | Varies (8) 06/08/2011 | |||||||||||||
| 7. | Title
and Amount of Underlying Securities (Instr. 3 and 4) |
8. | Price
of Derivative Security (Instr. 5) |
9. | Number
of Derivative Securities Beneficially Owned at End of Month (Instr. 4) |
10. | Ownership
Form of Derivative Security: Direct (D) or Indirect (I) |
11. | Nature
of Indirect Beneficial Ownership (Instr. 4) |
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| Common 333,332 | 333,332 | D | ||||||||||||
| Common 83,333 | 83,333 | D | ||||||||||||
| Common 230,000 | 230,000 | D | ||||||||||||
| Common 109,388 | 109,388 | D | ||||||||||||
| Explanation of Responses: See attached statement |
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| ** Intentional misstatements or omissions of
facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
/s/ Kellie J. Watts
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9/26/2001 | ||||||||||||
| ** Signature of Reporting Person | Date | |||||||||||||
| Attorney-in-Fact for J. Michael Parks |
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| Note: | File three copies of this Form, one of which
must be manually signed. If space is
insufficient, See Instruction 6 for procedure. |
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| Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. | ||||||||||||||
Alliance Data Systems Corporation ADS
| Form 4 - September 2001 | ||
| J.
Michael Parks 17655 Waterview Parkway Dallas, TX 75252-8012 |
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| Explanation of responses: | ||
| (1) | Purchase pursuant to SEC Release No. 44791 dated September 14, 2001, and extended with Release No. 44827 dated September 21, 2001. | |
| (2) | Total beneficial ownership includes 96,000 unvested shares of common stock pursuant to a restricted stock grant. | |
| (3) | The 44,444 option is exercisable for 11,111 shares on each of 1/31/98, 1/31/99, 1/31/00 and 1/31/01. | |
| (4) | The 177,777 option is exercisable for 16,666 shares on 1/31/98, 58,333 shares on 1/31/99, 58,333 shares on 1/31/00, and 44,445 shares on 1/31/01. | |
| (5) | The 111,111 option is exercisable on 1/31/99. | |
| (6) | This option is exercisable for 20,833 shares on each of 1/31/00, and 1/31/01, and 1/31/02, and for 20,834 shares on 1/31/03. | |
| (7) | This option is exercisable for 75,900 shares on each of 8/31/01, and 8/31/02, and for 78,200 shares on 8/31/03. | |
| (8) | The option is exercisable for 33% of the underlying shares on each of 6/7/02 and 6/7/03, and for 34% on 6/7/04. | |