Sec Form 5 Filing - CARLSON LEROY T JR @ TELEPHONE & DATA SYSTEMS INC /DE/ - 2021-12-31

Insider filing report for Changes in Beneficial Ownership
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FORM 5
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
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
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1. Name and Address of Reporting Person
CARLSON LEROY T JR
2. Issuer Name and Ticker or Trading Symbol
TELEPHONE & DATA SYSTEMS INC /DE/ [ TDS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
President and CEO
(Last) (First) (Middle)
30 N. LASALLE ST., STE. 4000
3. Date of Earliest Transaction (MM/DD/YY)
12/31/2021
(Street)
CHICAGO, IL60602
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction 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 Shares 05/22/2021 G V 16,000 D $ 0 57,351( 1 ) D
Common Shares 05/29/2021 G V 2,000 D $ 0 55,351( 1 ) D
Common Shares 09/09/2021 G V 5,005 D $ 0 50,346( 1 ) D
Common Shares 12/03/2021 G V 853 D $ 0 49,493( 1 ) D
Common Shares 12/30/2021 G V 1,474 D $ 0 49,894( 2 ) D
Common Shares 211,758( 3 ) I By trust
Common 78,943( 3 ) I By Trust
Common Shares 518 I By wife
Common Shares 22,279( 4 ) I By 401K
Common Shares 1,880,554( 5 )( 6 ) I By Voting Trust
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction 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
(MM/DD/YY)
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 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
Option (Right to Buy) $ 20.79 ( 7 ) 05/16/2022 Common Shares 309,200 309,200 D
Option (Right to Buy) $ 22.6 ( 7 ) 05/10/2023 Common Shares 186,000 186,000 D
Option (Right to Buy) $ 26.83 ( 7 ) 05/16/2024 Common Shares 225,000 225,000 D
Option (Right to Buy) $ 29.26 ( 7 ) 05/11/2025 Common Shares 236,100 236,100 D
Option (Right to Buy) $ 29.45 ( 7 ) 08/15/2026 Common Shares 53,800 53,800 D
Option (Right to Buy) $ 27.79 ( 7 ) 05/24/2027 Common Shares 39,700 39,700 D
Option (Right to Buy) $ 25.7 ( 7 ) 05/22/2028 Common Shares 18,320 18,320 D
Option (Rigft to Buy) $ 30.72 ( 7 ) 05/22/2029 Common Shares 33,624 33,624 D
Option (Right to Buy) $ 19.15 ( 7 ) 05/21/2030 Common Shares 77,100 77,100 D
Option (Rigft to Buy) $ 25.36 ( 7 ) 05/19/2031 Common 104,390 104,390 D
Restricted Stock Units ( 8 ) ( 8 ) 05/22/2022 Common Shares 60,630 60,630 D
Restricted Stock Units ( 8 ) ( 8 ) 05/21/2023 Common 82,507 82,507 D
Restricted Stock Units ( 8 ) ( 8 ) 05/24/2024 Common 136,827 136,827 D
Series A Common Shares ( 9 ) ( 9 ) ( 9 ) Common Shares 2,049,580 2,049,580( 10 ) I By Voting Trust
Deferred Compensation ( 11 ) ( 11 ) ( 11 ) Common Shares 73,339 73,339( 11 ) D
Series A Common Shares ( 9 ) ( 9 ) ( 9 ) Common Shares 11,142 11,142( 3 ) I By Trust
Series A Common Shares ( 9 ) ( 9 ) ( 9 ) Common Shares 11,424 11,424( 3 ) I By Trust
Series A Common Shares ( 9 ) ( 9 ) ( 9 ) Common Shares 297 297 I By Wife
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
CARLSON LEROY T JR
30 N. LASALLE ST., STE. 4000
CHICAGO, IL60602
X President and CEO
Signatures
Julie D. Mathews, by power of atty 01/18/2022
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Includes 3768 Common Shares owned by children. Reporting person disclaims beneficial ownership of shares owned by children.
( 2 )Includes 5242 Common Shares owned by children. Reporting person disclaims beneficial ownership of shares owned by children.
( 3 )Voluntary report of shares held in trust, the trustee of which is a third party and beneficiaries include the spouse and descendants
( 4 )Voluntary reporting of shares in TDS 401K. The information is based on a plan statement dated 12/31/21. The number of shares fluctuates and is attributable to the price of the shares on 12/31/21.
( 5 )Reporting person is one of four trustees which is record owner of these shares which files its holdings on forms 4. The shares reported are held by respective reporting person and his family members that have a pecuniary interest in such securities. Includes 690,604 Common Shares held by a family partnership of which reporting person is a general partner.
( 6 )On August 12, 201 the reporting person's spouse's GRAT transferred voting trust certificates representing 77,716 to the spouse individually. The reporting person previously reported all securities held by spouse and spouse's GRAT. Accordingly the transfer did not result in the change in the number of securities reported as beneficially owned by reporting person.
( 7 )Granted under the 2011 Long Term Incentive Plan. Options vest over a 3 year period with one-third becoming exercisable on the first anniversary, one-third on the second anniversary and one-third becoming exercisable on the third anniversary.
( 8 )Restricted stock unit award pursuant to the 2011 Long Term Incentive Plan. Stock units will become vested on third anniversary.
( 9 )Series A Common shares are convertible, on a share-for-share basis, into common shares.
( 10 )Reporting person is one of four trustees which is record owner of these shares which files its holdings on forms 4. The shares reported are held by respective reporting person and his family members that have a pecuniary interest in such securities. Includes 752,615 Series A Common Shares held by a family partnership of which reporting person is a general partner.
( 11 )Reporting person deferred bonuses pursuant to the TDS Long Term Incentive Plans. Employer matches vest ratably at a rate of 33%, 33%, 34% over three years. A total of 70,384 common shares units were vested at 12/31/21.

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).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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