0001181431-12-032511.txt : 20120524 0001181431-12-032511.hdr.sgml : 20120524 20120524181703 ACCESSION NUMBER: 0001181431-12-032511 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120523 FILED AS OF DATE: 20120524 DATE AS OF CHANGE: 20120524 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROBAK KIM M CENTRAL INDEX KEY: 0001264141 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14948 FILM NUMBER: 12868862 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FISERV INC CENTRAL INDEX KEY: 0000798354 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 391506125 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 255 FISERV DR STREET 2: PO BOX 979 CITY: BROOKFIELD STATE: WI ZIP: 53045 BUSINESS PHONE: 4148795000 MAIL ADDRESS: STREET 1: 255 FISERV DRIVE CITY: BROOKFIELD STATE: WI ZIP: 53045 4 1 rrd346623.xml X0305 4 2012-05-23 0 0000798354 FISERV INC FISV 0001264141 ROBAK KIM M MUELLER ROBAK, LLC 530 SOUTH 13TH STREET, SUITE 110 LINCOLN NE 68508 1 0 0 0 Common Stock 2012-05-23 4 A 0 900 0 A 9551 D Stock Option (right to buy) 66.70 2012-05-23 4 A 0 2726 0 A 2022-05-23 Common Stock 2726 2726 D These restricted stock units each represent a contingent right to receive one share of Fiserv common stock. The restricted stock units vest 100% on the earlier of: (i) the first anniversary of the grant date; or (ii) immediately prior to the first annual meeting of shareholders after the grant date. These options vest 100% on the earlier of: (i) the first anniversary of the grant date; or (ii) immediately prior to the first annual meeting of shareholders after the grant date. /s/ Thomas J. Hirsch (attorney-in-fact) 2012-05-24