Frank Bisignano - 01 Sep 2021 Form 4 Insider Report for FISERV INC (FI)

Role
President and CEO, Director
Signature
/s/ Eric C. Nelson (attorney-in-fact)
Issuer symbol
FI
Transactions as of
01 Sep 2021
Net transactions value
-$16,075,818
Form type
4
Filing time
02 Sep 2021, 16:16:22 UTC
Previous filing
17 Aug 2021
Next filing
23 Nov 2021
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction FI Common Stock Gift $0 -2,656 -0.11% $0.000000 2,311,970 20 Aug 2021 Direct
transaction FI Common Stock Options Exercise $13,810,476 +377,955 +16% $36.54 2,718,716 01 Sep 2021 Direct F1, F2
transaction FI Common Stock Tax liability $29,886,294 -252,546 -9.3% $118.34 2,466,170 01 Sep 2021 Direct F3
holding FI Common Stock 1,567 01 Sep 2021 See Footnote F4
holding FI Common Stock 120 01 Sep 2021 See Footnote F4
holding FI Common Stock 15,690 01 Sep 2021 By Spouse
holding FI Common Stock 76,713 01 Sep 2021 By Trust F5
holding FI Common Stock 46,209 01 Sep 2021 By Trust F6, F7

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction FI Employee Stock Option (right to buy) Options Exercise $0 -377,955 -23% $0.000000 1,259,857 01 Sep 2021 Common Stock 377,955 $36.54 Direct F8
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 This option exercise was effected pursuant to a Rule 10b5-1 trading plan entered into by the reporting person for estate and financial planning purposes.
F2 Reflects 28,791 shares distributed from the Frank J. Bisignano 2020 Grantor Retained Annuity Trust on September 1, 2021.
F3 Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options.
F4 These shares are held in an account, of which the reporting person acts as custodian, for the benefit of a minor.
F5 These shares are held by trusts, of which the reporting person serves as trustee, for the benefit of the reporting person's children.
F6 Reflects the distribution of 28,791 shares to the reporting person on September 1, 2021.
F7 Held by the Frank J. Bisignano 2020 Grantor Retained Annuity Trust.
F8 This option vested in five equal installments on each anniversary of the grant date, May 7, 2013.