SEC Form 4 · accession 0001209191-16-101620
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Rahul Gupta
Officer — Group President
Period of report
Feb 19, 2016
Accepted (ET)
Feb 23, 2016 · 7:26 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 | 1,294 | $0.00 | A | 89,179 | D | |
| Common StockF2 | Feb 19, 2016 | F | 743 | $96.65 | D | 88,436 | D | |
| Common StockF2 | Feb 20, 2016 | F | 5,931 | $96.65 | D | 82,505 | D | |
| Common StockF2 | Feb 22, 2016 | F | 1,394 | $97.92 | D | 81,111 | 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)F3 | $96.65 | Feb 19, 2016 | A | 11,970 | A | Feb 19, 2017 | Feb 19, 2026 | Common Stock | 11,970 | 11,970 | 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.
- F3One-third of these options vest on each anniversary of the grant date.