0001209191-17-053269.txt : 20170919 0001209191-17-053269.hdr.sgml : 20170919 20170919140713 ACCESSION NUMBER: 0001209191-17-053269 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170918 FILED AS OF DATE: 20170919 DATE AS OF CHANGE: 20170919 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROBAK KIM M CENTRAL INDEX KEY: 0001264141 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14948 FILM NUMBER: 171091685 MAIL ADDRESS: STREET 1: 530 SOUTH 13TH STREET STREET 2: SUITE 110 CITY: LINCOLN STATE: NE ZIP: 68508 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 2017-09-18 0 0000798354 FISERV INC FISV 0001264141 ROBAK KIM M MUELLER ROBAK, LLC 530 SOUTH 13TH STREET, SUITE 110 LINCOLN NE 68508 1 0 0 0 Common Stock 2017-09-18 4 M 0 6124 25.50 A 42141 D Common Stock 2017-09-18 4 S 0 6124 124.54 D 36017 D Stock Option (right to buy) 25.50 2017-09-18 4 M 0 6124 0.00 D 2009-05-20 2018-05-21 Common Stock 6124 0 D This transaction was executed in multiple trades at prices ranging from $124.42 to $124.68. 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 20, 2009. /s/ Lynn S. McCreary (attorney-in-fact) 2017-09-19