0001209191-17-001127.txt : 20170104 0001209191-17-001127.hdr.sgml : 20170104 20170104170217 ACCESSION NUMBER: 0001209191-17-001127 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170101 FILED AS OF DATE: 20170104 DATE AS OF CHANGE: 20170104 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: Hack Jeffrey I CENTRAL INDEX KEY: 0001654698 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11073 FILM NUMBER: 17506688 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 2017-01-01 0 0000883980 FIRST DATA CORP FDC 0001654698 Hack Jeffrey I C/O FIRST DATA CORPORATION 225 LIBERTY STREET, 29TH FLOOR NEW YORK NY 10281 0 1 0 0 See remarks Class B Common Stock 2017-01-01 4 F 0 5630 14.19 D Class A Common Stock 5630 41159 D 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. Represents shares withheld to pay tax obligations in connection with vesting of restricted stock. Includes 14,061 shares of restricted Class B common stock. Executive Vice President, Global Business Solutions /s/ Gretchen A. Herron, by power of attorney 2017-01-04