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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (right to buy) (6) | $ 39.73 | 12/03/2007 | A | 37,693 | (2) | 08/04/2016 | Common Stock | 37,693 | (3) | 37,693 | D | ||||
Stock Option (right to buy) (7) | $ 42.9 | 12/03/2007 | A | 17,983 | (4) | 08/05/2015 | Common Stock | 17,983 | (5) | 17,983 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KIGHT PETER J 4411 EAST JONES BRIDGE RD. NORCROSS, GA 30092 |
X |
/s/ Charles W. Sprague (attorney-in-fact) | 12/05/2007 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Restricted shares of common stock received in exchange for 91,319 shares of CheckFree Corporation restricted common stock priced at $48.00 per share in connection with the acquisition of CheckFree Corporation by Fiserv, Inc. (the "Merger"). The average closing sales price of Fiserv, Inc. common stock for the five full trading days immediately preceding the closing date of the Merger is $51.16. |
(2) | 50% of these options will vest on each of August 4, 2008 and August 4, 2009 respectively. |
(3) | Received in the Merger in exchange for employee stock options to acquire 40,175 shares of CheckFree Corporation common stock for $37.27. |
(4) | All of these options will vest on August 5, 2008. |
(5) | Received in the Merger in exchange for employee stock options to acquire 19,168 shares of CheckFree Corporation common stock for $40.25 per share. |
(6) | This Form 4/A is filed to correct a rounding error in the conversion amounts. |
(7) | This Form 4/A is filed to correct a rounding error in the conversion amounts. |