SEC Form 4 · accession 0001209191-17-011575
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeffery W Yabuki
Officer — President and CEO · Director
Period of report
Feb 14, 2017
Accepted (ET)
Feb 16, 2017 · 5:16 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 Stock | Feb 14, 2017 | M | 51,652 | $27.11 | A | 336,646 | D | |
| Common StockF1 | Feb 14, 2017 | F | 32,051 | $110.10 | D | 304,595 | D | |
| Common Stock | Feb 14, 2017 | M | 190,548 | $27.11 | A | 495,143 | D | |
| Common StockF1 | Feb 14, 2017 | F | 118,170 | $110.05 | D | 376,973 | D | |
| Common StockF2 | Feb 15, 2017 | S | 36,000 | $110.78 | D | 340,973 | D | |
| Common StockF3 | holding | — | — | — | 60,214 | I | By Trust |
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 | $27.11 | Feb 14, 2017 | M | 51,652 | D | Feb 27, 2011 | Feb 27, 2018 | Common Stock | 51,652 | 0 | D |
| Employee Stock Option (right to buy)F5 | $27.11 | Feb 14, 2017 | M | 190,548 | D | Feb 27, 2009 | Feb 27, 2018 | Common Stock | 190,548 | 0 | D |
Explanation of responses
- F1Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options.
- F2This transaction was executed in multiple trades at prices ranging from $110.55 to $111.10. 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.
- F3By the Yabuki Family Foundation of which Mr. Yabuki serves as trustee.
- F4This option vested in full on February 27, 2011.
- F5The option vested in three equal installments on February 27, 2009, 2010 and 2011.