SEC Form 4 · accession 0001209191-18-033089
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kim M Robak
Director
Period of report
May 23, 2018
Accepted (ET)
May 24, 2018 · 5:28 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 | 74,706 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Deferred Compensation Notional UnitsF3,F2 | — | holding | — | — | — | — | — | Common Stock | 15,862 | 15,862 | D |
| 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 | $51.23 | holding | — | — | — | May 18, 2017 | May 18, 2026 | Common Stock | 5,178 | 5,178 | D |
| Stock Option (right to buy)F2 | $40.56 | holding | — | — | — | May 18, 2016 | May 20, 2025 | Common Stock | 6,594 | 6,594 | D |
| Stock Option (right to buy)F2 | $29.95 | holding | — | — | — | May 20, 2015 | May 28, 2024 | Common Stock | 7,096 | 7,096 | D |
| Stock Option (right to buy)F2 | $22.34 | holding | — | — | — | May 22, 2014 | May 22, 2023 | Common Stock | 10,064 | 10,064 | D |
| Stock Option (right to buy)F2 | $16.68 | holding | — | — | — | May 22, 2013 | May 23, 2022 | Common Stock | 10,904 | 10,904 | D |
| Stock Option (right to buy)F2 | $15.65 | holding | — | — | — | May 23, 2012 | May 25, 2021 | Common Stock | 10,388 | 10,388 | 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.
- F3These deferred compensation notional units were allocated under the Fiserv, Inc. Non-Employee Director Deferred Compensation Plan (the "Plan"), under which director fees otherwise payable in cash may be deferred in exchange for the allocation of notional units under the Plan. The number of notional units credited is calculated by dividing the amount of compensation that is deferred by the closing price of the company's common stock on the date of deferral, or last business day prior. Upon termination of the reporting person's service to the company, each notional unit will be settled in shares of Fiserv, Inc. common stock on a one-for-one basis.