SEC Form 4 · accession 0001209191-18-000275

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 28, 2017

Accepted (ET)

Jan 2, 2018 · 5:02 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 28, 2017	C	277,134	$0.00	A	397,356	I	See footnote
Class A Common Stock	holding	—	—		—	7,107,398	D
Class A Common Stock^F4	holding	—	—		—	205,243	I	See footnote
Class A Common Stock	holding	—	—		—	1,900	I	By trust
Class A Common Stock	holding	—	—		—	25,800	I	By spouse
Class A Common Stock^F5	holding	—	—		—	15,190	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^F8,F6,F7	—	Dec 28, 2017	C	277,134	D	—	—	Class A Common Stock	0	0	I
Class B Common Stock^F6	—	holding	—	—	—	—	—	Class A Common Stock	1,928,281	1,928,281	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 2017 Grantor Retained Annuity Trust on December 28, 2017.
F3Held by the Frank J. Bisignano 2017 Grantor Retained Annuity Trust.
F4Held by the Frank J. Bisignano 2016 Grantor Retained Annuity Trust.
F5These shares are held in accounts for the benefit of the reporting person's children.
F6Shares 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.
F7Includes 216,394 shares of restricted Class B common stock.
F8Held by the Frank J. Bisignano 2015 Grantor Retained Annuity Trust.