Block, Inc. — Director's Dealing 2023

Oct 4, 2023

10/4/23, 3:07 PM

SEC FORM 4

SEC Form 4

FORM 4

Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940

OMB APPROVAL

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

Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b51(c). See Instruction 10.

1. Name and Address of Reporting Person* Meeker Mary G (Last) (First) (Middle) 1955 BROADWAY SUITE 600 (Street) OAKLAND CA 94612 (City) (State) (Zip)	1. Name and Address of Reporting Person* Meeker Mary G (Last) (First) (Middle) 1955 BROADWAY SUITE 600 (Street) OAKLAND CA 94612 (City) (State) (Zip)	1. Name and Address of Reporting Person* Meeker Mary G (Last) (First) (Middle) 1955 BROADWAY SUITE 600 (Street) OAKLAND CA 94612 (City) (State) (Zip)	1. Name and Address of Reporting Person* Meeker Mary G (Last) (First) (Middle) 1955 BROADWAY SUITE 600 (Street) OAKLAND CA 94612 (City) (State) (Zip)	1. Name and Address of Reporting Person* Meeker Mary G (Last) (First) (Middle) 1955 BROADWAY SUITE 600 (Street) OAKLAND CA 94612 (City) (State) (Zip)	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ]	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below)	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below)	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below)	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below)	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below)	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below)	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below)	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below)
					3. Date of Earliest Transaction (Month/Day/Year) 10/02/2023
					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
Table I - Non-Derivative 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)
										Code	V	Amount	(A) or (D)		Price
Class A Common Stock				10/02/2023						A		310 (1)	A		$ 0.00			410,998		D
Class A Common Stock																		5,817		I		See Footnote (2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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)
					Code		V	(A)	(D)	Date Exercisable		Expiration Date	Title	Amount or Number of Shares

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

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

1. Title of	2.	3. Transaction	3A. Deemed	4.		5.		6. Date Exercisable and	6. Date Exercisable and	7. Title and	8. Price of	9. Number of	10.	11. Nature
Derivative	Conversion	Date	Execution Date,	Transaction		Number		Expiration Date		Amount of	Derivative	derivative	Ownership	of Indirect
Security	or Exercise	(Month/Day/Year)	if any	Code	(Instr.	of		(Month/Day/Year)		Securities	Security	Securities	Form:	Beneficial
(Instr. 3)	Price of		(Month/Day/Year)	8)		Derivative				Underlying	(Instr. 5)	Beneficially	Direct (D)	Ownership
	Derivative					Securities				Derivative		Owned	or Indirect	(Instr. 4)
	Security					Acquired				Security		Following	(I) (Instr. 4)
						(A) or				(Instr. 3 and 4)		Reported
						Disposed						Transaction(s)
						of (D)						(Instr. 4)
						(Instr.	3, 4
						and 5)
										Amount
										or
										Number
								Date	Expiration	of
				Code	V	(A)	(D)	Exercisable	Date	Title Shares

Explanation of Responses:

1. Each share is represented by a restricted stock unit (RSU). Each RSU represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement. The RSUs were issued pursuant to the Issuer's Outside Director Compensation Policy, and 100% of the RSUs were vested as of the date of grant.

2. The shares are held directly by KPCB sFund Associates, LLC ("sFund Associates"). The reporting person is a member of sFund Associates and may be deemed to share voting and investment power over the securities held by sFund Associates. The reporting person disclaims beneficial ownership over such securities except to the extent of her pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.

Remarks:

/s/ Susan Szotek, Attorney-in10/04/2023 Fact

** 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.

https://www.sec.gov/Archives/edgar/data/1512673/000120919123052077/xslF345X05/doc4.xml

1/2

10/4/23, 3:07 PM

SEC FORM 4

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/1512673/000120919123052077/xslF345X05/doc4.xml

2/2