SEC Form 4 · accession 0001209191-17-054141

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

Sep 25, 2017

Accepted (ET)

Sep 27, 2017 · 5:10 pm EDT

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	Sep 25, 2017	C	4,960	$0.00	A	7,112,358	D
Class A Common Stock	Sep 25, 2017	G	4,960	$0.00	D	7,107,398	D
Class A Common Stock^F3	holding	—	—		—	325,465	I	See footnote
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^F5,F6	—	Sep 25, 2017	C	4,960	D	—	—	Class A Common Stock	4,960	1,968,476	D
Class B Common Stock^F3,F5	—	holding	—	—	—	—	—	Class A Common Stock	277,134	277,134	I

F1Each share of Class A Common Stock was issued upon the conversion of one share of Class B Common Stock.
F2Represents charitable donations of shares of Class A common stock by the reporting person.
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 are convertible into shares of 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 the issuer, automatically upon transfer, with certain exceptions, and upon certain other events.
F6Includes 216,394 shares of restricted Class B common stock.