Prepared by MerrillDirect
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
OMB APPROVAL
  STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP  
o Check this box if no longer
subject to Section 16.  Form 4
or Form 5 obligations may
continue.  See Instruction 1(b).
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(f) of the Investment Company Act of 1940
OMB Number:    3235-0287
Expires: December 31, 2001
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1.  Name and Address of Reporting Person* 2. Issuer Name and Ticker 4. Statement for 6. Relationship of Reporting Person(s) to Issuer
      or Trading Symbol   (Month/Year)   (Check all applicable)
Beltz, Michael A.   Alliance Data Systems Corporation ADS   September 2001   _______ Director   ______ 10% Owner
___X___ Officer    ______ Other

 

 

   
(Last) (First) (Middle)       Officer/Other Description       Executive Vice President and President, Transaction Services Group
           

17655 Waterview Parkway

3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) 5. If Amendment,
Date of Original
(Month/Year)
7. Individual or Joint/Group
Filing (Check Applicable Line)


          __ Form filed by More than One Reporting Person
X  Form filed by One Reporting Person
(Street)            
Dallas, TX 75252-8012            

           
(City) (State) (Zip)        
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security
(Instr. 3)
2. Transaction Date
(Month/Day/Year)
3. Transaction Code and Voluntary Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D) Of
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned at End of Month
(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/ D   |   Price            
  Common   09/25/2001   J   |   1,000(1)   |   A   |   $14.40   38,000 (2)   D    
                           
                           
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).

 

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)
4. Transaction Code
and Voluntary (V)
Code (Instr. 8)
5. Number of
Derivative
Securities
Acquired (A) or
isposed (D) Of
(Instr. 3, 4 and 5)
6. Date Exercisable(DE) and
Expiration Date(ED)
(Month/Day/Year)
               
     
                Code   |   V       Date
Exercisable
Expiration
Date
    Employee Stock Option (right to buy)   $9.00               Varies (3)   |  05/5/2007
                         
    Employee Stock Option (right to buy)   $9.00               Varies (4)   |  07/23/2008
                         
    Employee Stock Option (right to buy)   $9.90               Varies (5)   |  11/30/2008
                         
    Employee Stock Option (right to buy)   $9.90               Varies (6)   |  05/6/2009
                         
    Employee Stock Option (right to buy)   $15.00               Varies (7)   |  08/31/2010
                         
    Employee Stock Option (right to buy)   $12.00               Varies (8)   |  06/08/2011
                         
                         
                         

 

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 at End of
Month (Instr. 4)
10. Ownership Form of
Derivative Security:
Direct (D) or
Indirect (I)
11. Nature of Indirect Beneficial
Ownership (Instr. 4)
 
                     
                     
  Common – 44,444       44,444   D      
                     
  Common – 38,888       38,888   D      
                     
  Common – 27,777       27,777   D      
                     
  Common – 22,222       22,222   D      
                     
  Common – 80,000       80,000   D      
                     
  Common – 38,048       38,048   D      
                     
                     
                     
  Explanation of Responses:
See attached statement
       
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
         See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ Kellie J. Watts
9/26/2001  
  ** Signature of Reporting Person Date  
  Attorney-in-Fact for
Michael A. Beltz
   
       
Note: File three copies of this Form, one of which must be manually signed.  If space is insufficient,
See Instruction 6 for procedure.
   
       
Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.      
       

Alliance Data Systems Corporation  ADS

   
  Form 4 - September 2001
Beltz, Michael A.
17655 Waterview Parkway
Dallas, TX 75252-8012
 
   
Explanation of responses:  
   
(1) Purchase pursuant to SEC Release No. 44791 dated September 14, 2001, and extended with Release No. 44827 dated September 21, 2001.
(2) Total beneficial onwership includes 28,000 unvested shares of common stock pursuant to a restricted stock grant.
(3) The option became exercisable for 5,556 shares on 1/31/98, 13,888 shares on 1/31/99, 13,889 shares on 1/31/00, and 11,111 shares on 1/31/01.
(4) The option became exercisable for 9,722 shares on each of 1/31/99, 1/31/00, and 1/31/01, and becomes exercisable for 9,722 shares on 1/31/02.
(5) The option became exercisable for 6,944 shares on each of 1/31/99, 1/31/00, and 1/31/01, and becomes exercisable for 6,945 shares on 1/31/02.
(6) The option is exercisable for 5,556 shares on each of 1/31/00, 1/31/01, 1/31/02 and 1/31/03.
(7) The option becomes exercisable for 26,400 shares on each of 8/31/01 and 8/31/02 and for 27,200 shares on 8/31/03.
(8) The option is exercisable for 33% of the underlying shares on each of 6/7/02 and 6/7/03, and for 34% on 6/7/04.