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Block, Inc. Director's Dealing 2022

May 15, 2022

30034_rns_2022-05-15_12e2f899-810f-4a31-bfc8-91a3eb3a7b34.pdf

Director's Dealing

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5/13/22, 2:30 PM

SEC FORM 4

OMB APPROVAL OMB Number: 3235-0287 Estimated average burden hours per response: 0.5

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Check this box if no longer subject to STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estim ated average burd en
Section 16. Form 4 or Form 5 hours per response: 0.5
obligations may continue.See
Instruction 1(b).
Filed pursuant to Section 16(a) of the Securities Exchange Act of
or Section 30(h) of the Investment Company Act of 1940
1934
1. Name and Address of Reporting Person*
Henry Alyssa
2. Issuer NameandTicker
Block, Inc. [
SQ]
or Trading Symbol 5. Relationship of Reporting
(Check all applicable)
Director
Person(s) to Issuer
10% Owner
(Last)
(First)
1455 MARKET STREET
(Middle) 3. Date of Earliest Transaction (Month/Day/Year)
05/11/2022
X Officer (give
below)
title
Other (specify
below)
Square Lead
SUITE 600
(Street) 4. If Amendment, Date of Original Filed (Month/Day/Year) 6. Individual or Joint/Group Filing (Check Applicable Line)
SAN FRANCISCO
CA
94103 X Form filed by One Reporting Person
Form filed by More than One Reporting Person
(City)
(State)
(Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction 2A. Deemed 3. 4. Securities Acquired (A) or 5. Amount of 6. Ownership 7. Nature of
Date Execution Date, Transaction Disposed Of (D) (Instr. 3, 4 and Securities Form: Direct Indirect
(Month/Day/Year) if any Code (Instr. 5) Beneficially (D) or Indirect Beneficial
(Month/Day/Year) 8) Owned Following (I) (Instr. 4) Ownership
Reported (Instr. 4)
Code
V
Amount (A) or
(D)
Price Transaction(s)
(Instr. 3 and 4)
Class A Common Stock 05/11/2022 C
(1)
30,770 A $ 0.00 464,206 D
Class A Common Stock 05/11/2022 S
(2)
7,223 D $ 79
(3)
456,983 D
Class A Common Stock 05/11/2022 S
(2)
7,550 D $ 79.97
(4)
449,433 D
Class A Common Stock 05/11/2022 S
(2)
4,800 D $ 81.04
(5)
444,633 D
Class A Common Stock 05/11/2022 S
(2)
5,192 D $ 81.98
(6)
439,441 D
Class A Common Stock 05/11/2022 S
(2)
6,005 D $ 83.08
(7)
433,436 D

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned

(e.g., puts, calls, warrants, options, convertible securities)

1. Title of 1. Title of 2. 3. Transaction
3A. Deemed
4.
3. Transaction
3A. Deemed
4.
5. Number of 5. Number of 6. Date Exercisable and
7. Title and
6. Date Exercisable and
7. Title and
6. Date Exercisable and
7. Title and
6. Date Exercisable and
7. Title and
6. Date Exercisable and
7. Title and
6. Date Exercisable and
7. Title and
8. Price 8. Price of
9. Number of
10. 11. Nature
Derivative Conversion Date Execution Date,
Transaction
Derivative Expiration Date Amount of Derivative
derivative
Ownership of Indirect
Security or Exercise (Month/Day/Year)
if any
Code (Instr.
Securities (Month/Day/Year) Securities Security
Securities
Form: Beneficial
(Instr. 3) Price of (Month/Day/Year)
8)
Acquired (A) Underlying (Instr. 5)
Beneficially
Direct (D) Ownership
Derivative or Disposed Derivative Owned or Indirect (Instr. 4)
Security of (D) (Instr. Security (Instr. 3 Following (I) (Instr. 4)
3, 4 and 5) and 4) Reported
Amount Transaction(s)
(Instr. 4)
or
Number
Date Expiration of
Code
V
(A) (D) Exercisable Date Title Shares
Stock
Option
(right to
buy)
$ 7.254 05/11/2022 M 30,770 (8) 05/14/2024 Class B
Common
Stock
(9)
30,770 $ 0.00 1,569,230 D
Class B Class A
Common (9) 05/11/2022 M 30,770 (9) (9) Common 30,770 $ 0.00 30,770 D
Stock
(9)
Stock
Class B Class A
Common
Stock
(9)
(9) 05/11/2022 C
(1)
30,770 (9) (9) Common
Stock
30,770 $ 0.00 0 D

Explanation of Responses:

  1. Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person.

  2. The option exercise and sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan.

  3. The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $78.51 to $79.50 per share. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.

  4. The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $79.52 to $80.51 per share. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.

  5. The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $80.54 to $81.53 per share. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.

  6. The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $81.54 to $82.52 per share. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.

  7. The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $82.56 to $83.30 per share. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.

  8. 25% of the shares subject to the option vested on May 12, 2015 and 1/48th of the shares vested monthly thereafter.

  9. 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.

Remarks:

/s/ Susan Szotek, Attorney-in-Fact

05/13/2022

** 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).

https://www.sec.gov/Archives/edgar/data/1512673/000120919122028921/xslF345X03/doc4.xml

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5/13/22, 2:30 PM

SEC FORM 4

** 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/1512673/000120919122028921/xslF345X03/doc4.xml

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