0001209191-16-156120.txt : 20161220 0001209191-16-156120.hdr.sgml : 20161220 20161220164228 ACCESSION NUMBER: 0001209191-16-156120 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161216 FILED AS OF DATE: 20161220 DATE AS OF CHANGE: 20161220 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIRST DATA CORP CENTRAL INDEX KEY: 0000883980 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 470731996 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 225 LIBERTY STREET STREET 2: 29TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10281 BUSINESS PHONE: (800) 735-3362 MAIL ADDRESS: STREET 1: 225 LIBERTY STREET STREET 2: 29TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10281 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Larsen Christine E CENTRAL INDEX KEY: 0001654738 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11073 FILM NUMBER: 162061776 MAIL ADDRESS: STREET 1: C/O FIRST DATA CORPORATION STREET 2: FIRST DATA, 225 LIBERTY STREET CITY: NEW YORK STATE: NY ZIP: 10281 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-12-16 0 0000883980 FIRST DATA CORP FDC 0001654738 Larsen Christine E C/O FIRST DATA CORPORATION 225 LIBERTY STREET, 29TH FLOOR NEW YORK NY 10281 0 1 0 0 See remarks Class A Common Stock 2016-12-16 4 C 0 20500 0.00 A 461571 D Class A Common Stock 2016-12-16 5 G 0 E 20500 0.00 D 441071 D Class B Common Stock 2016-12-16 4 C 0 20500 0.00 D Class A Common Stock 20500 321070 D Each share of Class A Common Stock was issued upon the conversion of one share of Class B Common Stock. Represents a charitable donation of shares of Class A common stock by the reporting person. Shares of Class B common stock (Class B Common Stock) of First Data Corporation (FDC) are convertible into shares of Class A common stock of FDC (Class A Common Stock) on a one-for-one basis at any time at the option of the holder with the prior written consent of FDC, automatically upon transfer, with certain exceptions, and upon certain other events. Includes 139,596 shares of restricted Class B common stock. Executive Vice President, Chief Operations Officer /s/ Gretchen A. Herron, by power of attorney 2016-12-20