SEC Form 4 · accession 0001209191-18-058598
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
Nov 12, 2018
Accepted (ET)
Nov 14, 2018 · 6:00 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 | Nov 12, 2018 | M | 275,000 | $11.93 | A | 642,380 | D | |
| Common StockF1 | Nov 12, 2018 | F | 151,244 | $79.06 | D | 491,136 | D | |
| Common StockF2 | holding | — | — | — | 236,428 | 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)F3 | $11.93 | Nov 12, 2018 | M | 275,000 | D | Feb 24, 2011 | Feb 24, 2020 | Common Stock | 275,000 | 502,652 | D |
Explanation of responses
- F1Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options.
- F2By the Yabuki Family Foundation of which Mr. Yabuki serves as trustee.
- F3This option, representing a right to purchase a total of 777,652 shares, vested in three equal installments on February 24, 2011, 2012, and 2013.