Frank Bisignano - Dec 1, 2021 Form 4 Insider Report for FISERV INC (FI)

Role
President and CEO, Director
Signature
/s/ Eric C. Nelson (attorney-in-fact)
Stock symbol
FI
Transactions as of
Dec 1, 2021
Transactions value $
-$12,096,378
Form type
4
Date filed
12/3/2021, 04:26 PM
Previous filing
Nov 23, 2021
Next filing
Feb 1, 2022

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction FI Common Stock Gift $0 -1.67K -0.07% $0.00 2.47M Sep 17, 2021 Direct
transaction FI Common Stock Gift $0 -3.85K -0.16% $0.00 2.47M Nov 15, 2021 Direct
transaction FI Common Stock Gift $0 -1K -0.04% $0.00 2.47M Nov 17, 2021 Direct
transaction FI Common Stock Options Exercise $13.8M +378K +15.3% $36.54 2.85M Dec 1, 2021 Direct F1
transaction FI Common Stock Tax liability -$25.9M -271K -9.52% $95.55 2.58M Dec 1, 2021 Direct F2
holding FI Common Stock 430 Dec 1, 2021 See Footnote F3
holding FI Common Stock 1.57K Dec 1, 2021 See Footnote F3
holding FI Common Stock 15.7K Dec 1, 2021 By Spouse
holding FI Common Stock 76.7K Dec 1, 2021 By Trust F4
holding FI Common Stock 46.2K Dec 1, 2021 By Trust F5

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 -378K -30% $0.00 882K Dec 1, 2021 Common Stock 378K $36.54 Direct F1, F6
* 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 payment of exercise price and tax liability by withholding securities incident to exercise of stock options.
F3 These shares are held in an account, of which the reporting person acts as custodian, for the benefit of a minor.
F4 These shares are held by trusts, of which the reporting person serves as trustee, for the benefit of the reporting person's children.
F5 Held by the Frank J. Bisignano 2020 Grantor Retained Annuity Trust.
F6 This option vested in five equal installments on each anniversary of the grant date, May 7, 2013.