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Block, Inc. — Director's Dealing 2022
Dec 6, 2022
30034_rns_2022-12-06_f5d9ebf2-096f-4a5b-87ac-a9f9a4a8687e.pdf
Director's Dealing
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12/6/22, 2:04 PM
SEC FORM 4
SEC Form 4 FORM 4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
OMB APPROVAL OMB Number: 3235-0287 Estimated average burden hours per response: 0.5
Washington, D.C. 20549
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
| File Instruction 1(b). |
d pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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| 1. Name and Address of Reporting Person* Whiteley Sivan (Last) (First) (Middle) 1455 MARKET STREET SUITE 600 (Street) SAN FRANCISCO CA 94103 (City) (State) (Zip) |
2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ] |
5. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director 10% Owner X Officer (give title below) Other (specify below) Chief Legal Ofcr. & Corp. Sec. |
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| 3. Date of Earliest Transaction (Month/Day/Year) 12/02/2022 |
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| 4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line) X Form filed by One Reporting Person Form filed by More than One Reporting Person |
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| Table I - Non-D | erivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||||||||||
| 1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) |
2A. Deemed Execution Date, if any (Month/Day/Year) |
3. Transaction Code (Instr. 8) |
4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr. 4) |
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| Code | V | Amount | (A) or (D) |
Price | ||||||||||||||||||||
| Class A Common Stock | 11/15/2022 | A | V | 2 (1) |
A | $ 62.37 | 108,222 | D | ||||||||||||||||
| Class A Common Stock | 12/02/2022 | S | 106 (2) |
D | $ 67.29 | 108,116 | D | |||||||||||||||||
| Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) |
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| 1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security |
3. Transaction Date (Month/Day/Year) |
3A. Deemed Execution Date, if any (Month/Day/Year) |
4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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| Code | V | (A) | (D) | Date Exercisable |
Expiration Date |
Title | Amount or Number of Shares |
Explanation of Responses:
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These shares were acquired under the Issuer's Employee Stock Purchase Plan in a transaction that was exempt under both Rule 16b-3(d) and Rule 16b-3(c).
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Represents the number of shares automatically sold to satisfy the Issuer's income tax withholding and remittance obligations in connection with the vesting of restricted stock units. Remarks:
/s/ Susan Szotek, Attorney-in-Fact
12/06/2022
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
- If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.
https://www.sec.gov/Archives/edgar/data/1512673/000120919122060046/xslF345X03/doc4.xml
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