0000798354-24-000075.txt : 20240313 0000798354-24-000075.hdr.sgml : 20240313 20240313164912 ACCESSION NUMBER: 0000798354-24-000075 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240312 FILED AS OF DATE: 20240313 DATE AS OF CHANGE: 20240313 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gopal Ajei CENTRAL INDEX KEY: 0001302712 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38962 FILM NUMBER: 24746658 MAIL ADDRESS: STREET 1: CA, INC. STREET 2: ONE CA PLAZA CITY: ISLANDIA STATE: NY ZIP: 11749 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FISERV INC CENTRAL INDEX KEY: 0000798354 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] ORGANIZATION NAME: 07 Trade & Services IRS NUMBER: 391506125 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 600 N. VEL R. PHILLIPS AVENUE CITY: MILWAUKEE STATE: WI ZIP: 53203 BUSINESS PHONE: 4148795000 MAIL ADDRESS: STREET 1: 600 N. VEL R. PHILLIPS AVENUE CITY: MILWAUKEE STATE: WI ZIP: 53203 4 1 wk-form4_1710362933.xml FORM 4 X0508 4 2024-03-12 0 0000798354 FISERV INC FI 0001302712 Gopal Ajei 600 N. VEL R. PHILLIPS AVENUE MILWAUKEE WI 53203 1 0 0 0 0 Common Stock 2024-03-12 4 A 0 240 0 A 240 D These restricted stock units each represent a contingent right to receive one share of Fiserv, Inc. common stock. The restricted stock units vest 100% on the earlier of: (i) the first anniversary of the grant date or (ii) immediately prior to the first annual meeting of shareholders after the grant date. /s/ Eric C. Nelson (attorney-in-fact) 2024-03-13