-----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, FauRL2zubP/tZSQRJl0IylVE62IwElJ2AtnkY3IptxcYdgS3eTjicW7gcdfrtIzy wahRuIsO0cAFmfB2IHGp6w== 0000904454-04-000632.txt : 20041013 0000904454-04-000632.hdr.sgml : 20041013 20041013110704 ACCESSION NUMBER: 0000904454-04-000632 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031201 FILED AS OF DATE: 20041013 DATE AS OF CHANGE: 20041013 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: MACKESY D SCOTT CENTRAL INDEX KEY: 0001212997 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15749 FILM NUMBER: 041076341 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 X0202 4 2003-12-01 0001101215 ALLIANCE DATA SYSTEMS CORP ADS 0001212997 MACKESY D SCOTT C/O WELSH, CARSON, ANDERSON & STOWE 320 PARK AVENUE, SUITE 2500 NEW YORK NY 10022 0 0 1 0 Common Stock 2003-12-01 4 J 0 655555 0 A 655555 I By WCAS Capital Partners III, L.P. The Reporting Person became a managing member of the sole general partner of WCAS Capital Partners III, L.P. ("WCAS CP III") effective 12/01/03, and may therefore be deemed to have acquired indirect beneficial ownership of the securities held by such limited partnership as of that date. The Reporting Person also directly beneficially owns 3,852 shares of Common Stock and indirectly beneficially owns 17,790,349 shares of Common Stock held by Welsh, Carson, Anderson & Stowe VIII, L.P. ("WCAS VIII"). The Reporting Person is one of several managing members of the respective sole general partners of 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, that exceed his pecuniary interest therein, and/or that are not actually distributed to him. Jonathan M. Rather, Attorney-in-Fact 2004-10-13 -----END PRIVACY-ENHANCED MESSAGE-----