0001209191-16-156900.txt : 20161228
0001209191-16-156900.hdr.sgml : 20161228
20161228164737
ACCESSION NUMBER: 0001209191-16-156900
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161223
FILED AS OF DATE: 20161228
DATE AS OF CHANGE: 20161228
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: 162072937
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
2016-12-23
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
2016-12-23
4
C
0
33715
0.00
A
33715
I
See footnote
Class A Common Stock
441071
D
Class B Common Stock
2016-12-23
4
C
0
33715
0.00
D
Class A Common Stock
33715
287355
D
Each share of Class A Common Stock was issued upon the conversion of one share of Class B Common Stock.
Reflects shares contributed to The Christine Larsen 2016 Grantor Retained Annuity Trust on December 23, 2016.
Held by The Christine Larsen 2016 Grantor Retained Annuity Trust.
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
2016-12-28