-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, CNNULhVMkg1a5j0p6U0xnQuGmVZMoGRfm8/aW9E/kc4GHtLh+4PnhMEWuG+AhuxK htVMuxeHexFrSZnRnKN/EA== 0000904454-03-000608.txt : 20031028 0000904454-03-000608.hdr.sgml : 20031028 20031028141509 ACCESSION NUMBER: 0000904454-03-000608 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031024 FILED AS OF DATE: 20031028 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ALLIANCE DATA SYSTEMS CORP CENTRAL INDEX KEY: 0001101215 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 311429215 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 17655 WATERVIEW PARKWAY CITY: DALLAS STATE: TX ZIP: 75252 BUSINESS PHONE: 9723485100 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: QUAELLY PAUL B CENTRAL INDEX KEY: 0001212993 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15749 FILM NUMBER: 03960561 BUSINESS ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2128939500 MAIL ADDRESS: STREET 1: 320 PARK AVENUE STE 2500 CITY: NEW YORK STATE: NY ZIP: 10022 4 1 edgar.xml PRIMARY DOCUMENT X0201 42003-10-24 0001101215 ALLIANCE DATA SYSTEMS CORP ADS 0001212993 QUAELLY PAUL B C/O WELSH, CARSON, ANDERSON AND STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0010Common Stock2003-10-244S01069526.93D22149DThe Reporting Person also indirectly beneficially owns (i) 4,135,550 shares held by Welsh, Carson, Anderson & Stowe VI, L.P. ("WCAS VI"); (ii) 13,342,447 shares held by Welsh, Carson, Anderson & Stowe VII, L.P. ("WCAS VII"); (iii) 17,790,349 shares held by Welsh, Carson, Anderson & Stowe VIII, L.P. ("WCAS VIII"); and (iv) 655,555 shares held by WCAS Capital Partners III, L.P. ("WCAS CP III"). The Reporting Person is one of several managing members or general partners of the respective sole general partners of WCAS VI, WCAS VII, WCAS VIII and WCAS CP III. Pursuant to Instruction (4)(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such limited partnership. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, tha t exceed his pecuniary interest therein and/or that are not actually distributed to him. Jonathan M. Rather, Attorney-in-Fact2003-10-27 -----END PRIVACY-ENHANCED MESSAGE-----