SEC Form 4 · accession 0001209191-18-001079
FIRST DATA CORP · FDC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Christine E Larsen
Officer — See remarks
Period of report
Dec 31, 2017
Accepted (ET)
Jan 3, 2018 · 5:09 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 | Dec 31, 2017 | F | 27,793 | $16.71 | D | 597,068 | D | |
| Class A Common StockF2 | holding | — | — | — | 33,715 | I | See footnote | |
| Class A Common StockF3 | holding | — | — | — | 33,715 | I | See footnote |
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 StockF4 | — | Jan 1, 2018 | F | 14,536 | D | — | — | Class A Common Stock | 14,536 | 155,855 | D |
Explanation of responses
- F1Represents shares withheld to pay tax obligations in connection with vesting of restricted stock.
- F2Held by The Christine Larsen 2016 Grantor Retained Annuity Trust.
- F3Held by The Christine Larsen 2017 Grantor Retained Annuity Trust.
- F4Shares 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.
Remarks
Executive Vice President, Chief Operations Officer