0001209191-23-056697.txt : 20231127
0001209191-23-056697.hdr.sgml : 20231127
20231127174612
ACCESSION NUMBER: 0001209191-23-056697
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231124
FILED AS OF DATE: 20231127
DATE AS OF CHANGE: 20231127
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: 231441386
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-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
X0508
4
2023-11-24
0
0000798354
FISERV INC
FI
0001346629
Bisignano Frank
255 FISERV DRIVE
BROOKFIELD
WI
53045
1
1
0
0
Chairman, President and CEO
0
Common Stock
2023-11-24
4
G
0
1360
0.00
D
2923314
D
Common Stock
14235
I
By Spouse
Common Stock
4568
I
See Footnote
Common Stock
1012
I
See Footnote
Common Stock
582
I
See Footnote
Common Stock
17173
I
See Footnote
Common Stock
81550
I
By Trust
Includes 12,827 shares distributed from the Frank J. Bisignano 2022 Grantor Retained Annuity Trust to the reporting person on November 22, 2023.
These shares are held in an account, of which the reporting person acts as custodian, for the benefit of a minor.
Reflects the distribution of 12,827 shares to the reporting person on November 22, 2023.
Held by the Frank J. Bisignano 2022 Grantor Retained Annuity Trust.
These shares are held by trusts, of which the reporting person serves as trustee, for the benefit of the reporting person's children.
/s/ Eric C. Nelson (attorney-in-fact)
2023-11-27