0001209191-19-043535.txt : 20190729 0001209191-19-043535.hdr.sgml : 20190729 20190729171411 ACCESSION NUMBER: 0001209191-19-043535 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190729 FILED AS OF DATE: 20190729 DATE AS OF CHANGE: 20190729 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Distelbrink Ivo M CENTRAL INDEX KEY: 0001682238 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11073 FILM NUMBER: 19982203 MAIL ADDRESS: STREET 1: C/O FIRST DATA CORPORATION STREET 2: 225 LIBERTY STREET CITY: NEW YORK STATE: NY ZIP: 10281 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIRST DATA CORP CENTRAL INDEX KEY: 0000883980 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 470731996 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 225 LIBERTY STREET STREET 2: 29TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10281 BUSINESS PHONE: (800) 735-3362 MAIL ADDRESS: STREET 1: 225 LIBERTY STREET STREET 2: 29TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10281 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-07-29 1 0000883980 FIRST DATA CORP FDC 0001682238 Distelbrink Ivo M C/O FIRST DATA CORPORATION 225 LIBERTY STREET NEW YORK NY 10281 0 1 0 0 See remarks Class A Common Stock 2019-07-29 4 D 0 274114 D 0 D Stock Options (right to buy) 13.26 2019-07-29 4 D 0 42940 D 2026-08-15 Class A Common Stock 42940 0 D Includes 181,449 restricted stock units previously subject to time-based vesting which were converted into units denominated in shares of Fiserv, Inc. (Fiserv) common stock based on the exchange ratio (defined in footnote (2)) and will continue to be governed by the same terms and conditions as were applicable at the effective time in accordance with the Agreement and Plan of Merger dated January 16, 2019 (the Merger Agreement) among First Data Corporation (Issuer), Fiserv, and 300 Holdings, Inc. (Merger Sub). Pursuant to the Merger Agreement among Issuer, Fiserv, and Merger Sub, upon the effective time of the merger of Merger Sub into Issuer (the Merger) on July 29, 2019, each common share of the Issuer was converted in the right to receive 0.303 shares of Fiserv common stock (the exchange ratio). The options were originally scheduled to vest in equal annual installments on each of August 15, 2017, August 15, 2018, and August 15, 2019. Pursuant to the Merger Agreement, immediately after the effective time of the Merger, the option was converted into an option to purchase a number of shares of Fiserv common stock equal to the number of shares of Issuer common stock subject to such option award immediately prior the effective time multiplied by the exchange ratio, with an exercise price per share equal to the exercise price per share of such stock option immediately prior to the effective time divided by the exchange ratio. The options will continue to be governed by the same vesting terms as were applicable at the effective time. Executive Vice President /s/ Gretchen A. Herron, by power of attorney 2019-07-29