SEC Form 4 · accession 0001209191-17-062574
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kevin P. Gregoire
Officer — Group President
Period of report
Nov 22, 2017
Accepted (ET)
Nov 27, 2017 · 4:35 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 | Nov 22, 2017 | M | 11,604 | $32.64 | A | 48,609 | D | |
| Common Stock | Nov 22, 2017 | F | 7,443 | $127.86 | D | 41,166 | D | |
| Common Stock | Nov 22, 2017 | M | 9,950 | $40.35 | A | 51,116 | D | |
| Common Stock | Nov 22, 2017 | F | 6,671 | $127.86 | D | 44,445 | D | |
| Common Stock | Nov 22, 2017 | M | 7,991 | $56.97 | A | 52,436 | D | |
| Common Stock | Nov 22, 2017 | F | 5,858 | $127.872 | D | 46,578 | D | |
| Common StockF2 | Nov 22, 2017 | S | 9,573 | $127.80 | D | 37,005 | 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 | $32.64 | Nov 22, 2017 | M | 11,604 | D | Feb 22, 2013 | Feb 22, 2022 | Common Stock | 11,604 | 0 | D |
| Employee Stock Option (right to buy)F4 | $40.35 | Nov 22, 2017 | M | 9,950 | D | Feb 20, 2014 | Feb 20, 2023 | Common Stock | 9,950 | 0 | D |
| Employee Stock Option (right to buy)F5 | $56.97 | Nov 22, 2017 | M | 7,991 | D | Feb 19, 2015 | Feb 19, 2024 | Common Stock | 7,991 | 0 | D |
Explanation of responses
- F1Includes 216 shares acquired under the Fiserv, Inc. Employee Stock Purchase Plan.
- F2This transaction was executed in multiple trades at prices ranging from $127.684 to $127.94. 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.
- F3This option vested in three equal installments on each anniversary of the grant date, February 22, 2012.
- F4This option vested in three equal installments on each anniversary of the grant date, February 20, 2013.
- F5This option vested in three equal installments on each anniversary of the grant date, February 19, 2014.