SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
HORN CHARLES L

(Last) (First) (Middle)
7500 DALLAS PARKWAY, SUITE 700

(Street)
PLANO TX 75024

(City) (State) (Zip)
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
3. Date of Earliest Transaction (Month/Day/Year)
02/21/2013
4. If Amendment, Date of Original Filed (Month/Day/Year)
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. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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 02/21/2013 A(1) 4,185 A (1) 36,576 D
Common Stock 02/21/2013 F(2) 3,591 D $152.33 32,985 D
Common Stock 02/21/2013 A(3) 1,565 A (3) 34,550 D
Common Stock 02/21/2013 A(4) 6,263 A (4) 40,813 D
Common Stock 02/22/2013 F(2) 2,465 D $153.07 38,348(5) D
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 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: 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. Based on the Company's EBT performance in 2012, 150% of the original award of 8,369 performance-based restricted stock units granted 2/21/12 were earned, resulting in an additional 4,185 units, for a total of 12,554 units. The restrictions will lapse with respect to 4,143 units on 2/21/14 and with respect to 4,269 units on 2/23/15, subject to continued employment by the Reporting Person on the remaining vesting dates.
2. Shares withheld by the Company to satisfy the Reporting Person's tax withholding obligation upon the vesting of restricted stock units.
3. The new grant is for 1,565 shares of common stock represented by time-based restricted stock units. The restrictions will lapse on 516 units on each of 2/21/14 and 2/23/15 and on 533 units on 2/21/16, subject to continued employment by the Reporting Person on the vesting dates.
4. The new grant is for 6,263 shares of common stock represented by performance-based restricted stock units, which may be adjusted up or down at the time the performance restriction lapses. The restriction may lapse with respect to 33% of such shares on each of 2/21/14 and 2/23/15 and with respect to 34% of such shares on 2/21/16 contingent on meeting an EBT metric for 2013 and subject to continued employment by the Reporting Person on the vesting dates.
5. The total number of securities beneficially owned includes: (a) 14,515 unrestricted shares; (b) 884 unvested units from an award of 2,600 time-based restricted stock units granted 3/21/11; (c) 5,307 unvested units from an award of 15,605 performance-based restricted stock units granted 3/21/11; (d) 1,402 unvested units from an award of 2,092 time-based restricted stock units granted 2/21/12; (e) 8,412 unvested units from an award of 12,554 performance-based restricted stock units granted 2/21/12; (f) the new grant for 1,565 time-based restricted stock units; and (g) the new grant for 6,263 performance-based restricted stock units.
Remarks:
Cynthia L. Hageman, Attorney in Fact 02/25/2013
** Signature of Reporting Person Date
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).
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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