X0306 4 2012-10-26 1 0000844789 US HOME SYSTEMS INC USHS 0001249607 BUCHHOLZ DON A 1201 ELM STREET STE 3500 DALLAS TX 75270 1 0 0 0 Common Stock 2012-10-26 4 D 0 152710 12.50 D 0 D Non-Qualified Stock Option (right to buy) 1.85 2012-10-26 4 D 0 2000 10.65 D 2018-11-11 Common Stock 2000 0 D Non-Qualified Stock Option (right to buy) 2.76 2012-10-26 4 D 0 2000 9.74 D 2019-06-05 Common Stock 2000 0 D Non-Qualified Stock Option (right to buy) 3.28 2012-10-26 4 D 0 2000 9.22 D 2020-06-17 Common Stock 2000 0 D Non-Qualified Stock Option (right to buy) 5.13 2012-10-26 4 D 0 2000 7.37 D 2021-06-07 Common Stock 2000 0 D Non-Qualified Stock Option (right to buy) 9.10 2012-10-26 4 D 0 2000 3.40 D 2022-06-15 Common Stock 2000 0 D Disposed of pursuant to that certain Agreement and Plan of Merger (the "Merger Agreement") dated as of August 6, 2012 by and among U.S. Home Systems, Inc. (the "Company"), THD At-Home Services, Inc., and Umpire Acquisition Corp. in exchange for a payment of $12.50 per share in cash, without interest and less the amount of any required tax withholding. This option was canceled pursuant to the Merger Agreement in exchange for a payment in cash, without interest and less the amount of any required tax withholding, equal to the product of: (i) the excess of $12.50 (the per share merger consideration pursuant to the Merger Agreement) over the exercise price of the option; and (ii) the number of shares of Company common stock underlying the option. /s/ Don A. Buchholz 2012-10-26