0001209191-21-051839.txt : 20210817
0001209191-21-051839.hdr.sgml : 20210817
20210817161251
ACCESSION NUMBER: 0001209191-21-051839
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210815
FILED AS OF DATE: 20210817
DATE AS OF CHANGE: 20210817
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: 211182918
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
2021-08-15
0
0000798354
FISERV INC
FISV
0001346629
Bisignano Frank
255 FISERV DRIVE
BROOKFIELD
WI
53045
1
1
0
0
President and CEO
Common Stock
2021-08-15
4
F
0
149020
111.62
D
2314626
D
Common Stock
1567
I
See Footnote
Common Stock
120
I
See Footnote
Common Stock
15690
I
By Spouse
Common Stock
76713
I
By Trust
Common Stock
75000
I
By Trust
Reflects payment of tax liability by withholding securities incident to vesting of restricted stock units.
These shares are held in an account, of which the reporting person acts as custodian, for the benefit of a minor.
These shares are held by trusts, of which the reporting person serves as trustee, for the benefit of the reporting person's children.
Held by the Frank J. Bisignano 2020 Grantor Retained Annuity Trust.
/s/ Eric C. Nelson (attorney-in-fact)
2021-08-17