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Block, Inc. — Director's Dealing 2016
May 18, 2016
30034_dirs_2016-05-18_fec4667b-173d-429e-811d-a02f693572a3.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: KPCB DGF Associates, LLC (10% Owner)
Reporting Person: KPCB Digital Growth Founders Fund, LLC (10% Owner)
Reporting Person: KPCB Digital Growth Fund, LLC (10% Owner)
Non-Derivative Transactions
| Date | Security | Code | Shares | Price | A/D | Holdings After | Ownership |
|---|---|---|---|---|---|---|---|
| 2016-05-17 | Class A Common Stock | C | 8623410 | — | Acquired | 8623410 | Indirect |
Derivative Transactions
| Date | Security | Exercise Price | Code | Shares | A/D | Expiration | Underlying | Ownership |
|---|---|---|---|---|---|---|---|---|
| 2016-05-17 | Class B Common Stock | $ | C | 8623410 | Disposed | Class A Common Stock (8623410) | Indirect |
Footnotes
F1: All shares are held for convenience in the name of "KPCB Holdings, Inc. as nominee," for the accounts of such individuals and entities who each exercise their own voting and dispositive power over such shares. The managing member of KPCB Digital Growth Fund, LLC and KPCB DGF Founders Fund, LLC is KPCB DGF Associates, LLC. John Doerr, Ted Schlein, Brook Byers, Bing Gordon and Mary Meeker (collectively, the "Managing Members") are the managing members of KPCB DGF Associates, LLC, and, as such, may be deemed to have shared voting and dispositive power with respect to the issuer's securities held of record by KPCB Digital Growth Fund, LLC and KPCB DGF Founders Fund, LLC. [continued in next footnote]
F2: [continued from previous footnote] Each of entities and the Managing Members disclaims beneficial ownership of the securities reported herein, except to the extent of their respective pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of the shares for purposes of Section 16 or for any other purpose.
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: The holder elected to convert the shares of Class B Common Stock into Class A Common Stock.