SEC Form 4 · accession 0001209191-19-012228
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kevin J Schultz
Officer — EVP & President International
Period of report
Feb 19, 2019
Accepted (ET)
Feb 21, 2019 · 5:58 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 StockF1 | Feb 19, 2019 | F | 276 | $85.62 | D | 9,077 | D |
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)F2,F3 | $69.90 | holding | — | — | — | Feb 21, 2019 | Feb 21, 2028 | Common Stock | 26,786 | 26,786 | D |
| Employee Stock Option (right to buy)F2,F3 | $56.91 | holding | — | — | — | Feb 22, 2018 | Feb 22, 2027 | Common Stock | 10,754 | 10,754 | D |
| Employee Stock Option (right to buy)F2 | $48.33 | holding | — | — | — | Feb 19, 2017 | Feb 19, 2026 | Common Stock | 23,940 | 23,940 | D |
| Employee Stock Option (right to buy)F2 | $34.93 | holding | — | — | — | Nov 12, 2017 | Nov 12, 2024 | Common Stock | 25,932 | 25,932 | D |
Explanation of responses
- F1Reflects payment of tax liability by withholding securities incident to vesting of restricted stock units.
- F2Adjusted to reflect the two-for-one split of Fiserv, Inc. common stock distributed on March 19, 2018 to holders of record on March 5, 2018.
- F3One-third of these options vest on each anniversary of the grant date.