SEC Form 4 · accession 0001209191-18-033059
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John Y Kim
Director
Period of report
May 23, 2018
Accepted (ET)
May 24, 2018 · 5:07 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 StockF1,F2 | May 23, 2018 | A | 2,672 | $0.00 | A | 5,404 | 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 | $61.38 | holding | — | — | — | May 23, 2018 | May 24, 2027 | Common Stock | 4,288 | 4,288 | D |
| Stock Option (right to buy)F2 | $55.15 | holding | — | — | — | May 18, 2017 | Jul 11, 2026 | Common Stock | 4,100 | 4,100 | D |
Explanation of responses
- F1These restricted stock units each represent a contingent right to receive one share of Fiserv, Inc. common stock. The restricted stock units vest 100% on the earlier of: (i) the first anniversary of the grant date; or (ii) immediately prior to the first annual meeting of shareholders after the grant date.
- F2Adjusted 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.