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Block, Inc. Director's Dealing 2017

Feb 3, 2017

30034_dirs_2017-02-03_294c3b81-bf97-4f52-aa8e-7bc8d1455135.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: 2017-02-01

Reporting Person: Dorsey Jack (Director, President, CEO & Chairman, 10% Owner)

Non-Derivative Transactions

Date Security Code Shares Price A/D Holdings After Ownership
2017-02-01 Class A Common Stock C 7200 $0.00 Acquired 7200 Indirect
2017-02-01 Class A Common Stock G 7200 $0.00 Disposed 0 Indirect

Derivative Transactions

Date Security Exercise Price Code Shares A/D Expiration Underlying Ownership
2017-02-01 Class B Common Stock $ C 7200 Disposed Class A Common Stock (7200) Indirect

Holdings (Derivative)

Security Exercise Price Expiration Underlying Shares Ownership
Class B Common Stock $ Class A Common Stock (7952826) 7952826 Indirect
Class B Common Stock $ Class A Common Stock (503500) 503500 Indirect

Footnotes

F1: Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Jack Dorsey Revocable Trust u/a/d 12/8/10, for which the Reporting Person serves as Trustee.

F2: The shares are held of record by the Jack Dorsey Revocable Trust u/a/d 12/8/10.

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 Jack Dorsey Remainder Trust u/a/d 6/23/10, for which the Reporting Person serves as Trustee.

F5: The shares are held of record by Start Small, LLC, for which the Reporting Person is the sole member.