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Block, Inc. — Director's Dealing 2023
Jul 6, 2023
30034_rns_2023-07-06_2dcd0def-3f12-4eb0-841d-ba2adc6d51fa.pdf
Director's Dealing
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7/6/23, 2:09 PM
SEC FORM 4
SEC Form 4
FORM 4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
OMB APPROVAL
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). 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 Number: 3235-0287 Estimated average burden hours per response: 0.5
| Filed Instruction 1(b). |
Filed Instruction 1(b). |
Filed Instruction 1(b). |
Filed Instruction 1(b). |
Filed Instruction 1(b). |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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* Carter Shawn Corey (Last) (First) (Middle) 1955 BROADWAY SUITE 600 (Street) OAKLAND CA 94612 (City) (State) (Zip) |
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) |
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| 3. Date of Earliest Transaction (Month/Day/Year) 07/03/2023 |
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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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| Rule 10b5-1(c) Transaction Indication Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. |
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| 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) |
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| Code | V | Amount | (A) or (D) |
Price | |||||||||||||||||||
| Class A Common Stock | 07/03/2023 | A | 150 (1) |
A | $ 0.00 | 18,647 | D | ||||||||||||||||
| Class A Common Stock | 1,779 | I | By immediate family member (2) |
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| Class A Common Stock | 20,812 | I | See Footnote (3) |
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| Class A Common Stock | 296 | I | See Footnote (4) |
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| 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 |
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:
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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.
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The shares are held of record by an immediate family member of the Reporting Person.
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The shares are held of record by SC Panther, LLC, for which the Reporting Person serves as the sole member.
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The shares are held of record by SC Vessel 5, LLC, for which the Reporting Person serves as the sole member.
Remarks:
/s/ Susan Szotek, Attorney-in07/06/2023 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).
https://www.sec.gov/Archives/edgar/data/1512673/000120919123041595/xslF345X04/doc4.xml
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7/6/23, 2:09 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/1512673/000120919123041595/xslF345X04/doc4.xml
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