SEC FORM 4 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*
BREAM ROBERT W

(Last) (First) (Middle)
11720 AMBER PARK DRIVE
SUITE 600

(Street)
ALPHARETTA GA 30004

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CERTEGY INC [ CEY ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP and Group Executive
3. Date of Earliest Transaction (Month/Day/Year)
11/04/2004
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 11/04/2004 M 9,366 A $24.54 39,133 D
Common Stock 11/04/2004 S 9,366 D $35.1012 29,767 D
Common Stock 11/04/2004 M 5,104 A $32.55 34,871 D
Common Stock 11/04/2004 S 5,104 D $35.1012 29,767 D
Common Stock 11/04/2004 M 33,333 A $18.97 63,100 D
Common Stock 11/04/2004 S 33,333 D $35.1012 29,767 D
Common Stock 11/04/2004 M 21,687 A $18.97 51,454 D
Common Stock 11/04/2004 S 21,687 D $35.1012 29,767 D
Common Stock 11/04/2004 M 2,500 A $24.87 32,267 D
Common Stock 11/04/2004 S 2,500 D $35.1012 29,767 D
Common Stock 11/04/2004 M 825 A $29.46 30,592 D
Common Stock 11/04/2004 S 825 D $35.1012 29,767 D
Common Stock 11/05/2004 M 15,343 A $18.97 45,110 D
Common Stock 11/05/2004 S 8,400 D $35.4 36,710 D
Common Stock 89.11 I By 401(k) Plan
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) $24.54 11/04/2004 M 9,366 02/07/2003 02/07/2013 Common Stock 9,366 $0 0 D
Employee Stock Option (right to buy) $32.55 11/04/2004 M 5,104 (1) 02/04/2011 Common Stock 5,104 $0 14,897 D
Employee Stock Option (right to buy) $18.97 11/04/2004 M 33,333 (2) 09/23/2012 Common Stock 33,333 $0 66,667 D
Employee Stock Option (right to buy) $18.97 11/04/2004 M 21,687 (3) 09/23/2012 Common Stock 21,687 $0 7,229 D
Employee Stock Option (right to buy) $24.87 11/04/2004 M 2,500 (4) 03/24/2013 Common Stock 2,500 $0 2,500 D
Employee Stock Option (right to buy) $29.46 11/04/2004 M 825 (5) 06/16/2013 Common Stock 825 $0 825 D
Employee Stock Option (right to buy) $18.97 11/05/2004 M 15,343 (6) 09/23/2012 Common Stock 15,343 $0 5,271 D
Explanation of Responses:
1. The option consisting of 20,001 shares vests in four installments as follows: 5,104 shares on 2/4/2004, 5,104 and 4,689 shares, respectively, on 12/31/2004, 12/31/2005 and 12/31/2006.
2. The option consisting of 100,000 shares vests in two installments as follows: 33,333 shares on 1/28/2004 and 66,667 shares on 9/23/2009.
3. The option consisting of 28,916 shares fully vests in four equal annual installments of 7,229 shares each beginning on 9/23/2002, which was the date of grant.
4. The option consisting of 5,000 shares fully vests in two equal annual installments of 2,500 shares each beginning on 3/24/2004, which was the first anniversary of the date of grant.
5. The option consisting of 1,650 shares fully vests in two equal annual installments of 825 shares each beginning on 6/16/2004 which was the first anniversary of the date of grant.
6. The option consisting of 21,084 shares vests in four equal annual installments of 5,271 shares each beginning on 9/23/2002, which was the date of the grant.
Remarks:
Pamela Tefft, as Attorney-in-Fact for Robert W. Bream, pursuant to a Power of Attorney on File 11/08/2004
** 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.
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