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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) | $ 47.69 | 02/24/2010 | A | 17,706 | 02/24/2011(2) | 02/24/2020 | Common Stock | 17,706 | $ 0 | 17,706 | D | ||||
Stock option (right to buy) | $ 54.21 | 02/24/2010 | A | 3,228 (3) | 02/26/2011(4) | 02/27/2018 | Common Stock | 3,228 | $ 0 | 3,228 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
COX JAMES W 255 FISERV DRIVE BROOKFIELD, WI 53045 |
EVP - Corporate Development |
/s/ Thomas J. Hirsch (attorney-in-fact) | 02/26/2010 | |
**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) | One-third of these restricted stock units vest on the second anniversary of the grant date and an additional one-third will vest on each of the third and fourth anniversaries of the grant date. |
(2) | One-third of these options vest on each anniversary of the grant date. |
(3) | On February 27, 2008, the reporting person was granted an option to purchase 13,836 shares of common stock. The options vest in 2011 subject to Fiserv's achievement of annual or cumulative cost synergy goals and annual or cumulative internal revenue growth goals. The performance criteria with respect to the cost synergy goal for 2009 was achieved. Accordingly, 7/30 of the award was earned. |
(4) | The options will vest and become exercisable on the date in 2011 that the compensation committee certifies whether the 2010 and cumulative performance criteria have been satisfied. |