0001209191-21-029874.txt : 20210504
0001209191-21-029874.hdr.sgml : 20210504
20210504162128
ACCESSION NUMBER: 0001209191-21-029874
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20210430
FILED AS OF DATE: 20210504
DATE AS OF CHANGE: 20210504
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lynch Dennis
CENTRAL INDEX KEY: 0001425470
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38962
FILM NUMBER: 21888796
MAIL ADDRESS:
STREET 1: 3250 BRIARPARK, SUITE 400
CITY: HOUSTON
STATE: TX
ZIP: 77042
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
2021-04-30
0
0000798354
FISERV INC
FISV
0001425470
Lynch Dennis
255 FISERV DRIVE
BROOKFIELD
WI
53045
1
0
0
0
Common Stock
2021-04-30
4
M
0
6788
18.02
A
27119
D
Common Stock
2021-04-30
4
S
0
6788
120.00
D
20331
D
Stock Option (right to buy)
18.02
2021-04-30
4
M
0
6788
0.00
D
2013-05-23
2022-07-09
Common Stock
6788
0
D
This option exercise and sale was effected pursuant to a Rule 10b5-1 trading plan entered into by the reporting person for estate and financial planning purposes.
This option vested in full on May 23, 2013.
/s/ Eric C. Nelson (attorney-in-fact)
2021-05-04
EX-24.4_982336
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
Know all by these presents that the undersigned hereby constitutes and appoints
each of Frank J. Bisignano, Robert W. Hau, Eric C. Nelson and Jennifer M.
Manchester, signing singly, the undersigned's true and lawful attorney-in-fact
with respect to the undersigned's holdings of and transactions in securities
issued by Fiserv, Inc. to:
(1) execute for and on behalf of the undersigned Forms 3, 4 and 5 in accordance
with Section 16(a) of the Securities Exchange Act of 1934 and the rules
thereunder;
(2) do and perform any and all acts for and on behalf of the undersigned which
may be necessary or desirable to complete the execution of any such Form 3, 4 or
5 and the timely filing of such form with the United States Securities and
Exchange Commission ("SEC") and any other authority;
(3) do and perform any and all acts for and on behalf of the undersigned which
may be necessary or desirable, and to complete and execute any requests, forms
or documents, including without limitation completing, executing and submitting
an Update Passphrase request with the SEC and discussing the undersigned's EDGAR
access codes with the SEC (collectively, "Documents"), and timely submit or file
such Documents with the SEC, in connection with the maintenance and
administration of the undersigned's EDGAR access codes; and
(4) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve in the
undersigned's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform all and every act and exercise of any of the rights
and powers herein granted, as fully to all intents and purposes as such
attorney-in-fact might or could do if personally present, with full power of
substitution or revocation, hereby ratifying and confirming all that such
attorney-in-fact, or his or her substitute or substitutes, shall lawfully do or
cause to be done by virtue of this power of attorney and the rights and powers
herein granted. The undersigned acknowledges that the foregoing
attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming any of the undersigned's responsibilities to
comply with Section 16 of the Securities Exchange Act of 1934.
The undersigned hereby revokes any power of attorney granted by the undersigned
prior to the date hereof with respect to the undersigned's holdings of and
transactions in securities issued by Fiserv, Inc. This Power of Attorney shall
remain in full force and effect until the undersigned is no longer required to
file Forms 3, 4 or 5 with respect to the undersigned's holdings of and
transactions in securities issued by Fiserv, Inc., unless earlier revoked by the
undersigned in a signed writing delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed this 17th day of March, 2021.
/s/ Dennis F. Lynch
Signature
Dennis F. Lynch
Print Name