Annual Statement of Changes in Beneficial Ownership (5)
02 Février 2023 - 2:15PM
Edgar (US Regulatory)
FORM 5
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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).
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Form 3 Holdings Reported
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Form 4 Transactions Reported |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB Number:
3235-0362
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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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1. Name and Address of Reporting Person
*
CARLSON LEROY T JR | 2. Issuer Name and Ticker or Trading SymbolTELEPHONE & DATA SYSTEMS INC /DE/ [TDS] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President and CEO |
(Last)
(First)
(Middle)
30 N. LASALLE ST., STE. 4000 | 3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY) 12/31/2022 |
(Street)
CHICAGO, IL 60602
(City)
(State)
(Zip)
| 4. If Amendment, Date Original Filed(MM/DD/YYYY) | 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form Filed by One Reporting Person
___ Form Filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3) | 2. Trans. Date | 2A. Deemed Execution Date, if any | 3. Trans. 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) |
Amount | (A) or (D) | Price |
Common Shares | 10/16/2022 | | G | 10000 | D | $0 | 117029 (1) | D | |
Common Shares | 10/31/2022 | | G | 14000 | D | $0 | 103029 | D | |
Common Shares | 12/6/2022 | | G | 103029 | D | $0 | 0 (1) | D | |
Common Shares | | | | | | | 211758 (2) | I | By Trust |
Common | | | | | | | 78943 (2) | I | By Trust |
Common Shares | 10/16/2022 | | G | 10000 | A | $0 | 10518 | I | By wife |
Common Shares | 11/7/2022 | | G | 2586 | D | $0 | 7932 | I | By wife |
Common Shares | 12/6/2022 | | G | 103029 | A | $0 | 110961 | I | By wife |
Common Shares | | | | | | | 23493 (3) | I | By 401(k) |
Common Shares | | | | | | | 1759584 (1)(4) | I | By Voting Trust |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 (MM/DD/YYYY) | 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 at End of Issuer's Fiscal Year (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Series A Common Shares | | | | | | | (5) | (5) | Common Shares | 1918692.0 | | 1918692 (1)(6) | I | By Voting Trust |
Deferred Compensation | | | | | | | (7) | (7) | Common Shares | 81757.0 | | 81757 (7) | D | |
Series A Common Shares | | | | | | | (5) | (5) | Common Shares | 11424.0 | | 11424 (2) | I | By Trust |
Series A Common Shares | | | | | | | (5) | (5) | Common Shares | 11746.0 | | 11746 (2) | I | By Trust |
Series A Common Shares | | | | | | | (5) | (5) | Common Shares | 297.0 | | 297 | I | By Wife |
Explanation of Responses: |
(1) | Effective 12/31/22, reporting person is no longer including shares held by grown children no longer sharing his household in his ownership totals. |
(2) | Voluntary report of shares held in trust, the trustee of which is a third party and beneficiaries include reporting person's spouse and descendants |
(3) | The information is based on a plan statement dated 12/31/22. The number of shares fluctuates and is attributable to the price of the shares on 12/31/22. |
(4) | Reporting person is one of four trustees of a trust which is also a reporting person. The shares reported are held by respective reporting person and his family members that have a pecuniary interest in such securities. Includes 691,720 Common Shares held by a family partnership of which reporting person is a general partner. |
(5) | Series A Common shares are convertible, on a share-for-share basis, into common shares. |
(6) | Reporting person is one of four trustees of a trust which is also a reporting person. The shares reported are held by respective reporting person and his family members that have a pecuniary interest in such securities. Includes 753,934 Series A Common Shares held by a family partnership of which reporting person is a general partner. |
(7) | Reporting person deferred bonuses pursuant to the TDS Long Term Incentive Plans. Employer matches vest ratably at a rate of 33%, 33%, 34% over three years. A total of 78,879 common share units were vested at 12/31/22. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
CARLSON LEROY T JR 30 N. LASALLE ST., STE. 4000 CHICAGO, IL 60602 | X |
| President and CEO |
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Signatures
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Julie D. Mathews, by power of atty | | 2/2/2023 |
**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. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
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