SEC Form 4 · accession 0001209191-15-082062
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas J Hirsch
Officer — Chief Financial Officer
Period of report
Nov 23, 2015
Accepted (ET)
Nov 24, 2015 · 6:00 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000798354
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Nov 23, 2015 | M | 33,320 | $23.85 | A | 101,316 | D | |
| Common StockF2 | Nov 23, 2015 | F | 20,672 | $96.64 | D | 80,644 | D | |
| Common StockF3 | Nov 23, 2015 | S | 18,554 | $96.42 | D | 62,090 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (right to buy)F4 | $23.85 | Nov 23, 2015 | M | 33,320 | D | Feb 24, 2011 | Feb 24, 2020 | Common Stock | 33,320 | 0 | D |
Explanation of responses
- F1Transactions reported herein are for estate and financial planning purposes in anticipation of previously announced retirement on March 31, 2016.
- F2Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options.
- F3This transaction was executed in multiple trades at prices ranging from $96.36 to $96.61. The price reported above reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
- F4This option vested in three equal installments on each anniversary of the grant date, February 24, 2010.