SEC Form 4 · accession 0001209191-17-053269
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kim M Robak
Director
Period of report
Sep 18, 2017
Accepted (ET)
Sep 19, 2017 · 2:07 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 Stock | Sep 18, 2017 | M | 6,124 | $25.50 | A | 42,141 | D | |
| Common StockF1 | Sep 18, 2017 | S | 6,124 | $124.54 | D | 36,017 | 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)F2 | $25.50 | Sep 18, 2017 | M | 6,124 | D | May 20, 2009 | May 21, 2018 | Common Stock | 6,124 | 0 | D |
Explanation of responses
- F1This transaction was executed in multiple trades at prices ranging from $124.42 to $124.68. 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.
- F2This option vested in full on May 20, 2009.