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