| 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) | ||||||||||||||||||||||
| Tucker, Dwayne H. | Alliance Data Systems Corporation ADS | September 2001 | _______ Director ______ 10% Owner ___X__ Officer ______ Other |
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| (Last) | (First) | (Middle) | Officer/Other Description Executive Vice President, Chief Administrative 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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__ Form filed by More than One Reporting
Person X Form filed by 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 | 09/25/2001 | J | | 1,000(1) | A | $14.55 | 36,000 (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 Derivative 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 | Date Exercisable |
Expiration Date |
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| Employee Stock Option (right to buy) | $9.90 | Varies (3) | 05/31/2009 | ||||||||||||
| Employee Stock Option (right to buy) | $15.00 | Varies (4) | 08/31/2010 | ||||||||||||
| Employee Stock Option (right to buy) | $12.00 | Varies (5) | 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 - 27,777 | 27,777 | D | ||||||||||||
| Common - 115,000 | 115,000 | D | ||||||||||||
| Common - 81,917 | 81,917 | 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 Dwayne H. Tucker |
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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 | ||
| Tucker,
Dwayne H. 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 onwership includes 28,000 unvested shares of common stock pursuant to a restricted stock grant. | |
| (3) | The option is exercisable for 6,944 shares on each of 1/31/00, and 1/31/01; 6,944 shares on 1/31/02 and 6,945 shares on 1/31/03. | |
| (4) | The option is exercisable for 37,950 shares on each of 8/31/01 and 8/31/02, and for 39,100 shares on 8/31/03. | |
| (5) | 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. | |