0001209191-17-014488.txt : 20170224 0001209191-17-014488.hdr.sgml : 20170224 20170224180012 ACCESSION NUMBER: 0001209191-17-014488 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170222 FILED AS OF DATE: 20170224 DATE AS OF CHANGE: 20170224 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: YABUKI JEFFERY W CENTRAL INDEX KEY: 0001207371 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14948 FILM NUMBER: 17638871 MAIL ADDRESS: STREET 1: 255 FISERV DRIVE CITY: BROOKFIELD STATE: WI ZIP: 53045 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-02-22 0 0000798354 FISERV INC FISV 0001207371 YABUKI JEFFERY W 255 FISERV DRIVE BROOKFIELD WI 53045 1 1 0 0 President and CEO Common Stock 2017-02-22 4 A 0 39758 0.00 A 371151 D Common Stock 60214 I By Trust Employee Stock Option (right to buy) 113.82 2017-02-22 4 A 0 93409 0.00 A 2018-02-22 2027-02-22 Common Stock 93409 93409 D One-third of these restricted stock units vest on the second, third and fourth anniversaries of the grant date. By the Yabuki Family Foundation of which Mr. Yabuki serves as trustee. One-third of these options vest on each anniversary of the grant date. /s/ Lynn S. McCreary (attorney-in-fact) 2017-02-24