0001209191-22-049704.txt : 20220913 0001209191-22-049704.hdr.sgml : 20220913 20220913164211 ACCESSION NUMBER: 0001209191-22-049704 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220912 FILED AS OF DATE: 20220913 DATE AS OF CHANGE: 20220913 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DiSimone Harry CENTRAL INDEX KEY: 0001732108 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38962 FILM NUMBER: 221241212 MAIL ADDRESS: STREET 1: 18 HICKORY DRIVE CITY: OLD BROOKVILLE STATE: NY ZIP: 11545 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FISERV INC CENTRAL INDEX KEY: 0000798354 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] 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 2022-09-12 0 0000798354 FISERV INC FISV 0001732108 DiSimone Harry 255 FISERV DRIVE BROOKFIELD WI 53045 1 0 0 0 Common Stock 12947 D Common Stock 2022-09-12 4 S 0 2706 108.72 D 0 I By Trust Held by the Harry DiSimone 2021 Irrevocable Exemption Trust for the benefit of family members of the reporting person and of which such family members serve as trustee. /s/ Eric C. Nelson (attorney-in-fact) 2022-09-13