SEC Form 4 · accession 0001209191-18-032976
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
May 23, 2018
Accepted (ET)
May 24, 2018 · 4:27 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 StockF1 | May 23, 2018 | C | 25,575 | $0.00 | A | 690,909 | D | |
| Class A Common Stock | May 23, 2018 | G | 25,575 | $0.00 | D | 665,334 | D | |
| Class A Common StockF3 | holding | — | — | — | 33,715 | I | See footnote | |
| Class A Common StockF4 | holding | — | — | — | 20,489 | 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 StockF5 | — | May 23, 2018 | C | 25,575 | D | — | — | Class A Common Stock | 25,575 | 130,280 | D |
Explanation of responses
- F1Each share of Class A common stock was issued upon the conversion of one share of Class B common stock.
- F2Represents a charitable donation of shares of Class A common stock by the reporting person.
- F3Held by The Christine Larsen 2017 Grantor Retained Annuity Trust.
- F4Held by The Christine Larsen 2016 Grantor Retained Annuity Trust.
- 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.
Remarks
Executive Vice President, Chief Operations Officer