0001209191-20-013994.txt : 20200228 0001209191-20-013994.hdr.sgml : 20200228 20200228170421 ACCESSION NUMBER: 0001209191-20-013994 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200226 FILED AS OF DATE: 20200228 DATE AS OF CHANGE: 20200228 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: YABUKI JEFFERY W CENTRAL INDEX KEY: 0001207371 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38962 FILM NUMBER: 20671860 MAIL ADDRESS: STREET 1: 255 FISERV DRIVE CITY: BROOKFIELD STATE: WI ZIP: 53045 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FISERV INC CENTRAL INDEX KEY: 0000798354 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 391506125 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 255 FISERV DR STREET 2: PO BOX 979 CITY: BROOKFIELD STATE: WI ZIP: 53045 BUSINESS PHONE: 4148795000 MAIL ADDRESS: STREET 1: 255 FISERV DRIVE CITY: BROOKFIELD STATE: WI ZIP: 53045 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-02-26 0 0000798354 FISERV INC FISV 0001207371 YABUKI JEFFERY W 255 FISERV DRIVE BROOKFIELD WI 53045 1 1 0 0 Chairman and CEO Common Stock 2020-02-26 4 A 0 52415 0.00 A 415537 D Common Stock 341858 I By Trust Employee Stock Option (right to buy) 112.87 2020-02-26 4 A 0 168644 0.00 A 2021-02-26 2030-02-26 Common Stock 168644 168644 D One-fourth of these restricted stock units vest on each anniversary of the grant date. By the Yabuki Family Foundation of which Mr. Yabuki serves as trustee. One-fourth of these options vest on each anniversary of the grant date. /s/ Robert W. Hau (attorney-in-fact) 2020-02-28