Block, Inc. — Director's Dealing 2015

Nov 18, 2015

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: Square, Inc. (SQ)
CIK: 0001512673
Period of Report: 2015-11-18

Reporting Person: Wagner Dana (Gen. Counsel & Corp. Secretary)

Holdings (Non-Derivative)

Security	Shares	Ownership
Common Stock	309120	Indirect
Common Stock	67000	Direct

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Stock Option (right to buy)	$1.311	2021-08-10	Common Stock (960000)		Direct
Stock Option (right to buy)	$2.904	2023-05-31	Common Stock (103750)		Direct
Stock Option (right to buy)	$7.254	2024-02-27	Common Stock (250000)		Direct
Stock Option (right to buy)	$9.00	2025-11-18	Common Stock (200000)		Direct

Footnotes

F1: Each share of Common Stock shall be reclassified into one share of Class B Common Stock immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock.

F2: The shares are held of record by the Dana R. Wagner Living Trust, for which the Reporting Person serves as trustee.

F3: Each share is represented by a restricted stock unit (RSU). Each RSU represents a contingent right to receive one share of the Issuer's Common Stock upon settlement. 25% of the RSUs vest on November 1, 2016, and 1/12 of the remaining RSUs vest every three months thereafter.

F4: The shares subject to the option are fully vested and exercisable.

F5: 25% of the shares subject to the option vested on May 16, 2014 and 1/48 of the shares vest monthly thereafter.

F6: 20% of the shares subject to the option vested on February 24, 2015 and 1/60 of the shares vest monthly thereafter.

F7: 25% of the shares subject to the option vest on October 19, 2016 and 1/48 of the shares vest monthly thereafter.