Sec Form 4 Filing - King Timothy P @ ALLIANCE DATA SYSTEMS CORP - 2019-12-16

Insider filing report for Changes in Beneficial Ownership
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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
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
King Timothy P
2. Issuer Name and Ticker or Trading Symbol
ALLIANCE DATA SYSTEMS CORP [ ADS]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
EVP & Chief Financial Officer
(Last) (First) (Middle)
3075 LOYALTY CIRCLE
3. Date of Earliest Transaction (MM/DD/YY)
12/16/2019
(Street)
COLUMBUS, OH43219
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 Stock 12/16/2019 A( 1 ) 1,843 A 11,287.8393 ( 2 ) D
Common Stock 2,593.404 ( 3 ) I By 401(k) Plan
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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
King Timothy P
3075 LOYALTY CIRCLE
COLUMBUS, OH43219
EVP & Chief Financial Officer
Signatures
Cynthia L. Hageman, Attorney in Fact 12/18/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The new grant is for 1,843 shares of common stock represented by time-based restricted stock units. The restrictions will lapse on 608 units on each of 12/16/20 and 12/16/21 and on 627 units on 12/16/22, subject to continued employment by the Reporting Person on the vesting dates.
( 2 )The total number of securities beneficially owned includes: (a) 1,232.8393 unrestricted shares; (b) 245 unvested units from an award of 720 time-based restricted stock units granted 2/15/17; (c) 684 unvested units from an award of 2,010 performance-based restricted stock units granted 2/15/17; (d) 475 unvested units from an award of 708 time-based restricted stock units granted 2/15/18; (e) 1,439 unvested units from an award of 2,147 performance-based restricted stock units granted 2/15/18; (f) 1,073 unvested time-based restricted stock units granted 2/15/19; (g) 4,296 unvested performance-based restricted stock units granted 2/15/19; and (h) the new grant for 1,843 time-based restricted stock units.
( 3 )Includes 12.7058 shares acquired under Alliance Data's 401(k) plan since the date of the Reporting Person's last ownership report. The information in this report is based on a plan statement dated as of September 30, 2019.

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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