SEC Form 4 · accession 0001209191-16-124727
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Rahul Gupta
Officer — Group President
Period of report
May 27, 2016
Accepted (ET)
Jun 1, 2016 · 5:30 pm EDT
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 | May 27, 2016 | M | 14,444 | $23.85 | A | 95,798 | D | |
| Common StockF2 | May 27, 2016 | F | 8,819 | $104.97 | D | 86,979 | D | |
| Common Stock | May 27, 2016 | M | 15,364 | $30.86 | A | 102,343 | D | |
| Common StockF2 | May 27, 2016 | F | 9,897 | $104.98 | D | 92,446 | D | |
| Common Stock | May 27, 2016 | M | 25,528 | $32.64 | A | 117,974 | D | |
| Common StockF2 | May 27, 2016 | F | 16,662 | $104.99 | D | 101,312 | D | |
| Common Stock | May 27, 2016 | M | 27,860 | $40.35 | A | 129,172 | D | |
| Common StockF2 | May 27, 2016 | F | 19,215 | $104.99 | D | 109,957 | D | |
| Common StockF3 | May 27, 2016 | S | 28,603 | $105.01 | D | 81,354 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F4 | $23.85 | May 27, 2016 | M | 14,444 | D | Feb 24, 2011 | Feb 24, 2020 | Common Stock | 14,444 | 0 | D |
| Stock Option (right to buy)F5 | $30.86 | May 27, 2016 | M | 15,364 | D | Feb 23, 2012 | Feb 23, 2021 | Common Stock | 15,364 | 0 | D |
| Stock Option (right to buy)F6 | $32.64 | May 27, 2016 | M | 25,528 | D | Feb 22, 2013 | Feb 22, 2022 | Common Stock | 25,528 | 0 | D |
| Stock Option (right to buy)F7 | $40.35 | May 27, 2016 | M | 27,860 | D | Feb 20, 2014 | Feb 20, 2023 | Common Stock | 27,860 | 0 | D |
Explanation of responses
- F1Includes 243 shares acquired under the Fiserv, Inc. Employee Stock Purchase Plan.
- 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 $104.95 to $105.01. 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.
- F4The option vested in three equal installments on February 24, 2011, 2012 and 2013.
- F5The option vested in three equal installments on February 23, 2012, 2013 and 2014.
- F6The option vested in three equal installments on February 22, 2013, 2014 and 2015.
- F7The option vested in three equal installments on February 20, 2014, 2015 and 2016.