SEC Form 4 · accession 0001209191-17-065466
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
Dec 11, 2017
Accepted (ET)
Dec 13, 2017 · 4:59 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 | Dec 11, 2017 | M | 5,500 | $69.85 | A | 13,731 | D | |
| Common Stock | Dec 11, 2017 | F | 4,199 | $131.70 | D | 9,532 | D | |
| Common StockF2 | Dec 11, 2017 | S | 3,439 | $131.51 | D | 6,093 | 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 | $69.85 | Dec 11, 2017 | M | 5,500 | D | Nov 12, 2017 | Nov 12, 2024 | Common Stock | 5,500 | 12,966 | 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 $131.33 to $131.76. 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 vests in two equal installments on the third and fourth anniversaries of the grant date, November 12, 2014.