0001209191-21-020225.txt : 20210312 0001209191-21-020225.hdr.sgml : 20210312 20210312171323 ACCESSION NUMBER: 0001209191-21-020225 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210310 FILED AS OF DATE: 20210312 DATE AS OF CHANGE: 20210312 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simons Doyle CENTRAL INDEX KEY: 0001185922 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38962 FILM NUMBER: 21738472 MAIL ADDRESS: STREET 1: 220 OCCIDENTAL AVENUE SOUTH CITY: SEATTLE STATE: WA ZIP: 98104 FORMER NAME: FORMER CONFORMED NAME: SIMONS DOYLE R DATE OF NAME CHANGE: 20020904 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 2021-03-10 0 0000798354 FISERV INC FISV 0001185922 Simons Doyle 255 FISERV DRIVE BROOKFIELD WI 53045 1 0 0 0 Common Stock 2021-03-10 4 M 0 10388 15.65 A 89427 D Common Stock 2021-03-10 4 S 0 10388 122.10 D 79039 D Stock Option (right to buy) 15.65 2021-03-10 4 M 0 10388 0.00 D 2012-05-25 2021-05-25 Common Stock 10388 0 D This transaction was executed in multiple trades at prices ranging from $122.01 to $122.20. The price reported above reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. This option vested in full on May 25, 2012. /s/ Robert W. Hau (attorney-in-fact) 2021-03-12