0001209191-17-035267.txt : 20170525
0001209191-17-035267.hdr.sgml : 20170525
20170525141826
ACCESSION NUMBER: 0001209191-17-035267
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170524
FILED AS OF DATE: 20170525
DATE AS OF CHANGE: 20170525
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: Simons Doyle
CENTRAL INDEX KEY: 0001185922
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-14948
FILM NUMBER: 17869485
MAIL ADDRESS:
STREET 1: 220 OCCIDENTAL AVENUE SOUTH
CITY: SEATTLE
STATE: WA
ZIP: 98104
FORMER NAME:
FORMER CONFORMED NAME: SIMONS DOYLE R
DATE OF NAME CHANGE: 20020904
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-05-24
0
0000798354
FISERV INC
FISV
0001185922
Simons Doyle
220 OCCIDENTAL AVENUE SOUTH
SEATTLE
WA
98104
1
0
0
0
Common Stock
2017-05-24
4
A
0
701
0.00
A
18147
D
Stock Option (right to buy)
122.76
2017-05-24
4
A
0
2144
0.00
A
2027-05-24
Common Stock
2144
2144
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/ Lynn S. McCreary (attorney-in-fact)
2017-05-25