SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
CARLSON LEROY T JR

(Last) (First) (Middle)
30 N. LASALLE ST., STE. 4000

(Street)
CHICAGO IL 60602

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
TELEPHONE & 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
3. Date of Earliest Transaction (Month/Day/Year)
05/19/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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)
Code V Amount (A) or (D) Price
Common Shares 03/20/2021 G V 3,307 D $0 74,610(1) D
Common Shares 03/26/2021 G V 11,500 D $0 63,110(1) D
Common Shares 04/13/2021 G V 12,000 D $0 51,110(1) D
Common Shares 05/15/2021 G V 11,000 D $0 40,110(1) D
Common Shares 03/08/2021 G V 251,993 D $0 1,874,514(2)(3) I By Voting Trust
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) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction 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 (Month/Day/Year) 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 Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option (Right to Buy) $25.36 05/19/2021 A 104,390 05/19/2024(4) 05/19/2031 Common Shares 104,390 $0(4) 104,390 D
Restricted Stock Units (5) 05/19/2021 A 136,827 (5) (5) Common Shares 136,827 (5) 136,827 D
Series A Common Shares (6) 03/08/2021 G V 9,218 (6) (6) Common Shares 9,218 $0 2,042,841(7)(8) I By Voting Trust
Explanation of Responses:
1. Includes 3768 shares owned by children. Reporting person disclaims beneficial ownership of shares owned by children.
2. On March 8, 2021 the reporting person's spouse individually transferred 162,314 Common Shares and 89,679 Common Shares from her Marital Trust to a trust, the trustee of which is a family member. The reporting person previous reported all securities held by spouse and spouse's Marital Trust. Accordingly, the transfer did not result in the change in the number of securities reported as beneficially owned by reporting person.
3. Reporting person is one of four trustees which is record owner of these shares and files its holdings on forms 4. Of these Common shares, shares are held by respective reporting person and his family members.
4. Options granted pursuant to the 2020 Long-Term Incentive Plan. Options become exercisable on May 19, 2024.
5. Restricted stock unit award pursuant to the 2020 Long Term Incentive Plan. Stock units will become vested on third anniversary.
6. Series A Common shares are convertible, on a share-for-share basis, into common shares.
7. Reporting person is one of four trustees which is record owner of these shares and files its holdings on forms 4. Of these Series A Common Shares, shares are held by respective reporting person and his family members.
8. On March 8, 2021, the reporting person's spouse individually transferred 9,218 Series A common Shares to a trust, the trustee of which is a family member. The reporting person previously reported all securities held by spouse. Accordingly, the transfer did not result in the change in the number of securities reported as beneficially owned by reporting person.
Remarks:
Julie D. Mathews, by power of atty 05/20/2021
** 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 Number.