SEC Form 4 · accession 0001209191-16-101610
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
Feb 19, 2016
Accepted (ET)
Feb 23, 2016 · 7:02 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 | Feb 19, 2016 | A | 7,114 | $0.00 | A | 69,204 | D | |
| Common StockF2 | Feb 19, 2016 | F | 1,355 | $96.65 | D | 67,849 | D | |
| Common StockF2 | Feb 20, 2016 | F | 1,880 | $96.65 | D | 65,969 | D | |
| Common StockF2 | Feb 22, 2016 | F | 3,041 | $97.92 | D | 62,928 | D | |
| Common Stock | Feb 22, 2016 | M | 74,068 | $30.86 | A | 136,996 | D | |
| Common StockF3 | Feb 22, 2016 | F | 48,510 | $97.86 | D | 88,486 | D | |
| Common Stock | Feb 22, 2016 | M | 55,696 | $32.64 | A | 144,182 | D | |
| Common StockF3 | Feb 22, 2016 | F | 36,980 | $97.95 | D | 107,202 | D | |
| Common StockF4,F5 | Feb 22, 2016 | S | 44,274 | $97.77 | D | 62,928 | 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)F6 | $96.65 | Feb 19, 2016 | A | 21,944 | A | Feb 19, 2017 | Feb 19, 2026 | Common Stock | 21,944 | 21,944 | D |
| Employee Stock Option (right to buy)F7 | $30.86 | Feb 22, 2016 | M | 74,068 | D | Feb 23, 2012 | Feb 23, 2021 | Common Stock | 74,068 | 0 | D |
| Employee Stock Option (right to buy)F8 | $32.64 | Feb 22, 2016 | M | 55,696 | D | Feb 22, 2013 | Feb 22, 2022 | Common Stock | 55,696 | 0 | D |
Explanation of responses
- F1One-third of these restricted stock units vest on the second, third and fourth anniversaries of the grant date.
- F2Reflects payment of tax liability by withholding securities incident to vesting of restricted stock units.
- F3Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options.
- F4For estate and financial planning purposes in anticipation of previously announced retirement.
- F5This transaction was executed in multiple trades at prices ranging from $97.53 to $97.99. 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.
- F6One-third of these options vest on each anniversary of the grant date.
- F7This option vested in three equal installments on each anniversary of the grant date, February 23, 2011.
- F8This option vested in three equal installments on each anniversary of the grant date, February 22, 2012.