Fiserv (FI) Form 4 FISERV / Frank Bisignano ownership change

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

Bisignano Frank

(Last) (First) (Middle)

255 FISERV DRIVE

(Street)

BROOKFIELD WI 53045

(City) (State) (Zip)

2. Issuer Name and Ticker or Trading Symbol
FISERV INC [ FISV ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Chairman, President and CEO

3. Date of Earliest Transaction (Month/Day/Year)
05/08/2023

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
			Code	V	Amount	(A) or (D)	Price
Common Stock	04/28/2023		G	V	3,639	D	$0.00	2,869,650	D
Common Stock	05/08/2023		M		109,278	A	$46.97	2,978,928	D
Common Stock	05/08/2023		M		223,669	A	$52.81	3,202,597	D
Common Stock	05/08/2023		F		243,544(1)	D	$119.5	2,959,053	D
Common Stock								4,286	I	See Footnote(2)
Common Stock								81,550	I	By Trust(3)
Common Stock								30,000	I	See Footnote(4)
Common Stock								730	I	See Footnote(2)
Common Stock								14,940	I	By Spouse
Common Stock								300	I	See Footnote(2)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
				Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Employee Stock Option (right to buy)	$46.97	05/08/2023		M			109,278	01/01/2016(5)	01/28/2025	Common Stock	109,278	$0.00	0	D
Employee Stock Option (right to buy)	$52.81	05/08/2023		M			223,669	09/09/2019(6)	10/15/2025	Common Stock	223,669	$0.00	0	D

Explanation of Responses:

1. Reflects payment of exercise price and tax liability by withholding securities incident to exercise of stock options.

2. These shares are held in an account, of which the reporting person acts as custodian, for the benefit of a minor.

3. These shares are held by trusts, of which the reporting person serves as trustee, for the benefit of the reporting person's children.

4. Held by the Frank J. Bisignano 2022 Grantor Retained Annuity Trust.

5. This option vested in three equal installments on each anniversary of January 1, 2015.

6. This option vested on September 9, 2019, upon the satisfaction of certain performance conditions.

Remarks:

	/s/ Eric C. Nelson (attorney-in-fact)	05/10/2023
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.