SEC Form 4 · accession 0001209191-18-028677
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Doyle Simons
Director
Period of report
May 7, 2018
Accepted (ET)
May 8, 2018 · 5:47 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 StockF1 | May 7, 2018 | M | 12,248 | $12.75 | A | 56,974 | 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)F1,F2 | $12.75 | May 7, 2018 | M | 12,248 | D | May 20, 2009 | May 21, 2018 | Common Stock | 12,248 | 0 | D |
| Stock Option (right to buy)F1 | $61.38 | holding | — | — | — | May 23, 2018 | May 24, 2027 | Common Stock | 4,288 | 4,288 | D |
| Stock Option (right to buy)F1 | $51.23 | holding | — | — | — | May 18, 2017 | May 18, 2026 | Common Stock | 5,178 | 5,178 | D |
| Stock Option (right to buy)F1 | $40.56 | holding | — | — | — | May 18, 2016 | May 20, 2025 | Common Stock | 6,594 | 6,594 | D |
| Stock Option (right to buy)F1 | $29.95 | holding | — | — | — | May 20, 2015 | May 28, 2024 | Common Stock | 7,096 | 7,096 | D |
| Stock Option (right to buy)F1 | $22.34 | holding | — | — | — | May 22, 2014 | May 22, 2023 | Common Stock | 10,064 | 10,064 | D |
| Stock Option (right to buy)F1 | $16.68 | holding | — | — | — | May 22, 2013 | May 23, 2022 | Common Stock | 10,904 | 10,904 | D |
| Stock Option (right to buy)F1 | $15.65 | holding | — | — | — | May 23, 2012 | May 25, 2021 | Common Stock | 10,388 | 10,388 | D |
| Stock Option (right to buy)F1 | $11.62 | holding | — | — | — | May 25, 2011 | May 26, 2020 | Common Stock | 13,728 | 13,728 | D |
| Stock Option (right to buy)F1 | $10.34 | holding | — | — | — | May 20, 2010 | May 20, 2019 | Common Stock | 15,316 | 15,316 | D |
Explanation of responses
- F1Adjusted to reflect the two-for-one split of Fiserv, Inc. common stock distributed at the close of business on March 19, 2018 to holders of record on March 5, 2018.
- F2This option vested in full on May 20, 2009.