0001209191-19-060098.txt : 20191211
0001209191-19-060098.hdr.sgml : 20191211
20191211180409
ACCESSION NUMBER: 0001209191-19-060098
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191209
FILED AS OF DATE: 20191211
DATE AS OF CHANGE: 20191211
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: 001-38962
FILM NUMBER: 191280579
MAIL ADDRESS:
STREET 1: 255 FISERV DRIVE
CITY: BROOKFIELD
STATE: WI
ZIP: 53045
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
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-12-09
0
0000798354
FISERV INC
FISV
0001207371
YABUKI JEFFERY W
255 FISERV DRIVE
BROOKFIELD
WI
53045
1
1
0
0
Chairman and CEO
Common Stock
2019-12-09
4
M
0
658380
15.43
A
869809
D
Common Stock
2019-12-09
4
F
0
356319
114.85
D
513490
D
Common Stock
2019-12-10
4
S
0
45000
114.29
D
468490
D
Common Stock
344080
I
By Trust
Employee Stock Option (right to buy)
15.43
2019-12-09
4
M
0
658380
0.00
D
2012-02-23
2021-02-23
Common Stock
658380
0
D
Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options.
This transaction was executed in multiple trades at prices ranging from $113.96 to $114.62. The price reported above reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
By the Yabuki Family Foundation of which Mr. Yabuki serves as trustee.
This option vested in three equal installments on February 23, 2012, 2013 and 2014.
/s/ Robert W. Hau (attorney-in-fact)
2019-12-11