SEC Form 4 · accession 0001209191-16-153398

FIRST DATA CORP · FDC

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Chief Executive Officer · Director

Period of report

Dec 1, 2016

Accepted (ET)

Dec 5, 2016 · 5:05 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000883980

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Class A Common Stock^F1,F2,F3	Dec 1, 2016	C	325,465	$0.00	A	325,465	I	See footnote
Class A Common Stock	holding	—	—		—	1,708,140	D
Class A Common Stock	holding	—	—		—	1,900	I	By Trust
Class A Common Stock	holding	—	—		—	5,800	I	By Spouse
Class A Common Stock^F4	holding	—	—		—	10,190	I	See footnote

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Class B Common Stock^F6,F5	—	Dec 1, 2016	C	325,465	D	—	—	Class A Common Stock	325,465	277,134	I
Class B Common Stock^F5,F7	—	holding	—	—	—	—	—	Class A Common Stock	2,281,471	2,281,471	D

F1Each share of Class A Common Stock was issued upon the conversion of one share of Class B Common Stock.
F2Reflects shares contributed to the Frank J. Bisignano 2016 Grantor Retained Annuity Trust on December 1, 2016.
F3Held by the Frank J. Bisignano 2016 Grantor Retained Annuity Trust.
F4These shares are held in accounts for the benefit of the reporting person's children.
F5Shares of Class B common stock (Class B Common Stock) of First Data Corporation (FDC) are convertible into shares of Class A common stock of FDC (Class A Common Stock) on a one-for-one basis at any time at the option of the holder with the prior written consent of FDC, automatically upon transfer, with certain exceptions, and upon certain other events.
F6Held by the Frank J. Bisignano 2015 Grantor Retained Annuity Trust.
F7Includes 788,697 shares of restricted Class B Common Stock.