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Block, Inc. — Director's Dealing 2016
May 19, 2016
30034_dirs_2016-05-19_05988795-bbff-4e18-830d-252541980741.zip
Director's Dealing
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SEC Form 4 — Statement of Changes in Beneficial Ownership
Issuer: Square, Inc. (SQ)
CIK: 0001512673
Period of Report: 2016-05-17
Reporting Person: Summers Lawrence Henry (Director)
Non-Derivative Transactions
| Date | Security | Code | Shares | Price | A/D | Holdings After | Ownership |
|---|---|---|---|---|---|---|---|
| 2016-05-17 | Class A Common Stock | C | 108613 | $0.00 | Acquired | 108613 | Indirect |
| 2016-05-17 | Class A Common Stock | G | 108613 | $0.00 | Disposed | 0 | Indirect |
Derivative Transactions
| Date | Security | Exercise Price | Code | Shares | A/D | Expiration | Underlying | Ownership |
|---|---|---|---|---|---|---|---|---|
| 2016-05-17 | Class B Common Stock | $ | C | 108613 | Disposed | Class A Common Stock (108613) | Indirect | |
| 2016-05-18 | Class B Common Stock | $ | G | 740679 | Disposed | Class A Common Stock (740679) | Direct | |
| 2016-05-18 | Class B Common Stock | $ | G | 740679 | Acquired | Class A Common Stock (740679) | Indirect |
Holdings (Derivative)
| Security | Exercise Price | Expiration | Underlying | Shares | Ownership |
|---|---|---|---|---|---|
| Class B Common Stock | $ | Class A Common Stock (108613) | 108613 | Indirect | |
| Class B Common Stock | $ | Class A Common Stock (57818) | 57818 | Indirect | |
| Class B Common Stock | $ | Class A Common Stock (925679) | 925679 | Direct |
Footnotes
F1: Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the LHS 2014 Qualified Annuity Trust #1S dated February 13, 2014 (LHS 2014 #1S), for which the Reporting Person serves as trustee.
F2: The shares are held of record by LHS 2014 #1S.
F3: Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date.
F4: Reflects the transfer from LHS 2014 #1S to the Reporting Person as an annuity payment.
F5: Reflects the transfer from the LHS 2015 Qualified Annuity Trust #2S dated March 26, 2015 (LHS 2015 #2S), for which the Reporting Person serves as trustee, to the Reporting Person as an annuity payment.
F6: The shares are held of record by LHS 2015 #2S.
F7: Reflects the transfers from LHS 2014 #1S and LHS 2015 #2S to the Reporting Person as annuity payments.
F8: The shares are held of record by the LHS 2016 Qualified Annuity Trust - Square, for which the Reporting Person serves as trustee.