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Block, Inc. — Director's Dealing 2016
Dec 8, 2016
30034_dirs_2016-12-08_82516df0-eb3c-42ee-999e-1bf89440aa8d.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: 2016-12-07
Reporting Person: Summers Lawrence Henry (Director)
Non-Derivative Transactions
| Date | Security | Code | Shares | Price | A/D | Holdings After | Ownership |
|---|---|---|---|---|---|---|---|
| 2016-12-07 | Class A Common Stock | C | 23125 | $0.00 | Acquired | 50507 | Direct |
| 2016-12-07 | Class A Common Stock | S | 23125 | $13.75 | Disposed | 27382 | Direct |
Derivative Transactions
| Date | Security | Exercise Price | Code | Shares | A/D | Expiration | Underlying | Ownership |
|---|---|---|---|---|---|---|---|---|
| 2016-12-07 | Class B Common Stock | $ | C | 23125 | Disposed | Class A Common Stock (23125) | Direct |
Holdings (Derivative)
| Security | Exercise Price | Expiration | Underlying | Shares | Ownership |
|---|---|---|---|---|---|
| Class B Common Stock | $ | Class A Common Stock (57818) | 57818 | Indirect | |
| Class B Common Stock | $ | Class A Common Stock (740679) | 740679 | Indirect |
Footnotes
F1: Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person.
F2: The sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person.
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 shares are held of record by the LHS 2015 Qualified Annuity Trust #2S dated March 26, 2015, for which the Reporting Person serves as trustee.
F5: The shares are held of record by the LHS 2016 Qualified Annuity Trust - Square, for which the Reporting Person serves as trustee.