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