0001209191-22-005999.txt : 20220201
0001209191-22-005999.hdr.sgml : 20220201
20220201175936
ACCESSION NUMBER: 0001209191-22-005999
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220128
FILED AS OF DATE: 20220201
DATE AS OF CHANGE: 20220201
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Chiarello Guy
CENTRAL INDEX KEY: 0001654667
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38962
FILM NUMBER: 22580490
MAIL ADDRESS:
STREET 1: 225 LIBERTY STREET
STREET 2: 29TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10281
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FISERV INC
CENTRAL INDEX KEY: 0000798354
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
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
2022-01-28
0
0000798354
FISERV INC
FISV
0001654667
Chiarello Guy
255 FISERV DRIVE
BROOKFIELD
WI
53045
0
1
0
0
Chief Operating Officer
Common Stock
2022-01-28
4
M
0
12592
36.54
A
208967
D
Common Stock
2022-01-28
4
S
0
10000
100.40
D
198967
D
Common Stock
2022-01-28
4
S
0
2592
105.00
D
196375
D
Common Stock
2022-01-29
4
F
0
6422
104.89
D
189953
D
Common Stock
2022-01-31
4
M
0
8408
36.54
A
198361
D
Common Stock
2022-01-31
4
S
0
8408
105.00
D
189953
D
Common Stock
26118
I
By Trust
Common Stock
37381
I
By Trust
Employee Stock Option (right to buy)
36.54
2022-01-28
4
M
0
12592
0.00
D
2014-07-11
2023-07-11
Common Stock
12592
92408
D
Employee Stock Option (right to buy)
36.54
2022-01-31
4
M
0
8408
0.00
D
2014-07-11
2023-07-11
Common Stock
8408
84000
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.
Reflects payment of tax liability by withholding securities incident to vesting of restricted stock units.
This transaction was executed in multiple trades at prices ranging from $105.00 to $105.03. 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.
Held by The Guy Chiarello 2020 Trust for the benefit of the reporting person's spouse and children and of which the reporting person's spouse serves as trustee and the reporting person serves as investment advisor.
Held by The Denise Chiarello 2021 Trust for the benefit of the reporting person and the reporting person's children and of which the reporting person serves as trustee. This previously reported holding, with respect to which there were no transactions, was inadvertently omitted from the reporting person's filings in December 2021 and January 2022.
This option vested in five equal installments on each anniversary of the grant date, July 11, 2013.
/s/ Eric C. Nelson (attorney-in-fact)
2022-02-01