SEC Form 4 · accession 0001209191-17-014464
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kevin J Schultz
Officer — Group President
Period of report
Feb 22, 2017
Accepted (ET)
Feb 24, 2017 · 5:40 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,F2 | Feb 22, 2017 | A | 1,758 | $0.00 | A | 9,524 | 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 | $113.82 | Feb 22, 2017 | A | 5,377 | A | Feb 22, 2018 | Feb 22, 2027 | Common Stock | 5,377 | 5,377 | D |
Explanation of responses
- F1One-third of these restricted stock units vest on the second, third and fourth anniversaries of the grant date.
- F2Includes 243 shares acquired under the Fiserv, Inc. Employee Stock Purchase Plan.
- F3One-third of these options vest on each anniversary of the grant date.