SEC Form 4 · accession 0001209191-19-012733
FISERV INC · FISV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert W. Hau
Officer — Chief Financial Officer
Period of report
Feb 20, 2019
Accepted (ET)
Feb 22, 2019 · 5:45 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,F2,F3 | Feb 20, 2019 | A | 14,753 | $0.00 | A | 96,309 | 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)F4 | $84.73 | Feb 20, 2019 | A | 43,968 | A | Feb 20, 2020 | Feb 20, 2029 | Common Stock | 43,968 | 43,968 | D |
| Employee Stock Option (right to buy)F3,F4 | $69.90 | holding | — | — | — | Feb 21, 2019 | Feb 21, 2028 | Common Stock | 51,340 | 51,340 | D |
| Employee Stock Option (right to buy)F3,F4 | $56.91 | holding | — | — | — | Feb 22, 2018 | Feb 22, 2027 | Common Stock | 43,012 | 43,012 | D |
| Employee Stock Option (right to buy)F3,F5 | $49.21 | holding | — | — | — | Mar 14, 2019 | Mar 14, 2026 | Common Stock | 188,088 | 188,088 | D |
Explanation of responses
- F1One-third of these restricted stock units vest on the second, third and fourth anniversaries of the grant date.
- F2Includes 236 shares acquired under the Fiserv, Inc. Employee Stock Purchase Plan.
- F3Adjusted 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.
- F4One-third of these options vest on each anniversary of the grant date.
- F5One-half of these options vest on the third and fourth anniversaries of the grant date.