SEC Form 4 · accession 0001209191-18-012070
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 16, 2018
Accepted (ET)
Feb 21, 2018 · 5:56 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 16, 2018 | M | 363,984 | $16.37 | A | 567,035 | D | |
| Common StockF1 | Feb 16, 2018 | F | 193,270 | $142.295 | D | 373,765 | D | |
| Common StockF2 | Feb 18, 2018 | F | 2,553 | $142.72 | D | 371,212 | D | |
| Common StockF2 | Feb 19, 2018 | F | 7,312 | $142.72 | D | 363,900 | D | |
| Common StockF3 | holding | — | — | — | 118,214 | 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 | $16.37 | Feb 16, 2018 | M | 363,984 | D | Feb 26, 2010 | Feb 26, 2019 | Common Stock | 363,984 | 0 | D |
Explanation of responses
- F1Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options.
- F2Reflects payment of tax liability by withholding securities incident to vesting of restricted stock units.
- F3By the Yabuki Family Foundation of which Mr. Yabuki serves as trustee.
- F4The option vested in three equal installments on February 26, 2010, 2011 and 2012.