0001209191-21-021774.txt : 20210318 0001209191-21-021774.hdr.sgml : 20210318 20210318163852 ACCESSION NUMBER: 0001209191-21-021774 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210316 FILED AS OF DATE: 20210318 DATE AS OF CHANGE: 20210318 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bisignano Frank CENTRAL INDEX KEY: 0001346629 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38962 FILM NUMBER: 21754851 MAIL ADDRESS: STREET 1: 225 LIBERTY STREET, 29TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10281 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 2021-03-16 0 0000798354 FISERV INC FISV 0001346629 Bisignano Frank 255 FISERV DRIVE BROOKFIELD WI 53045 1 1 0 0 President and CEO Common Stock 2021-03-02 5 G 0 E 10151 0.00 D 2190945 D Common Stock 2021-03-03 5 G 0 E 1760 0.00 D 2189185 D Common Stock 2021-03-08 5 G 0 E 418 0.00 D 2188767 D Common Stock 2021-03-12 5 G 0 E 240 0.00 D 2188527 D Common Stock 2021-03-12 5 G 0 E 120 0.00 A 1567 I See Footnote Common Stock 2021-03-12 5 G 0 E 120 0.00 A 120 I See Footnote Common Stock 2021-03-16 4 M 0 503941 36.54 A 2692468 D Common Stock 2021-03-16 4 F 0 322127 124.12 D 2370341 D Common Stock 2021-03-18 5 G 0 E 2827 0.00 D 2367514 D Common Stock 15690 I By Spouse Common Stock 76713 I By Trust Common Stock 75000 I By Trust Employee Stock Option (right to buy) 36.54 2021-03-16 4 M 0 503941 0.00 D 2014-05-07 2023-05-07 Common Stock 503941 2015767 D These shares are held in an account, of which the reporting person acts as custodian, for the benefit of a minor. Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options. These shares are held by trusts for the benefit of the reporting person's children and of which the reporting person serves as trustee. Held by the Frank J. Bisignano 2020 Grantor Retained Annuity Trust. This option vested in five equal installments on each anniversary of the grant date, May 7, 2013. /s/ Robert W. Hau (attorney-in-fact) 2021-03-18 EX-24.4_974241 2 poa.txt POA DOCUMENT POWER OF ATTORNEY Know all by these presents that the undersigned hereby constitutes and appoints each of Frank J. Bisignano, Robert W. Hau, Eric C. Nelson and Jennifer M. Manchester, signing singly, the undersigned's true and lawful attorney-in-fact with respect to the undersigned's holdings of and transactions in securities issued by Fiserv, Inc. to: (1) execute for and on behalf of the undersigned Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder; (2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete the execution of any such Form 3, 4 or 5 and the timely filing of such form with the United States Securities and Exchange Commission ("SEC") and any other authority; (3) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable, and to complete and execute any requests, forms or documents, including without limitation completing, executing and submitting an Update Passphrase request with the SEC and discussing the undersigned's EDGAR access codes with the SEC (collectively, "Documents"), and timely submit or file such Documents with the SEC, in connection with the maintenance and administration of the undersigned's EDGAR access codes; and (4) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in the undersigned's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform all and every act and exercise of any of the rights and powers herein granted, as fully to all intents and purposes as such attorney-in-fact might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or his or her substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934. The undersigned hereby revokes any power of attorney granted by the undersigned prior to the date hereof with respect to the undersigned's holdings of and transactions in securities issued by Fiserv, Inc. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 or 5 with respect to the undersigned's holdings of and transactions in securities issued by Fiserv, Inc., unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed this 17th day of March, 2021. /s/ Frank J. Bisignano Signature Frank J. Bisignano Print Name