0001209191-23-012864.txt : 20230224 0001209191-23-012864.hdr.sgml : 20230224 20230224180929 ACCESSION NUMBER: 0001209191-23-012864 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230222 FILED AS OF DATE: 20230224 DATE AS OF CHANGE: 20230224 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: 23669217 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 2023-02-22 0 0000798354 FISERV INC FISV 0001654667 Chiarello Guy 255 FISERV DRIVE BROOKFIELD WI 53045 0 1 0 0 Chief Operating Officer Common Stock 2023-02-22 4 A 0 40783 0.00 A 229075 D Common Stock 2023-02-23 4 F 0 6892 116.54 D 222183 D Common Stock 26118 I By Trust Common Stock 37381 I By Trust One-third of these restricted stock units vest on each anniversary of the grant date. Reflects payment of tax liability by withholding securities incident to vesting of restricted stock units. 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. /s/ Eric C. Nelson (attorney-in-fact) 2023-02-24