SEC Form 4 · accession 0001209191-17-060701
FIRST DATA CORP · FDC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Adam L. Rosman
Officer — See remarks
Period of report
Nov 12, 2017
Accepted (ET)
Nov 14, 2017 · 5:46 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000883980
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class B Common StockF1,F3 | — | Nov 12, 2017 | F | 21,735 | D | — | — | Class A Common Stock | 21,735 | 121,257 | D |
Explanation of responses
- F1Shares 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.
- F2Represents shares withheld to pay tax obligations in connection with vesting of restricted stock.
- F3Includes 18,982 shares of restricted Class B common stock.
Remarks
Executive Vice President, General Counsel and Secretary