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