Block, Inc. — Director's Dealing 2023

Apr 30, 2023

4/28/23, 3:50 PM

SEC FORM 4

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

OMB APPROVAL

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

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

1. Name and Address of Reporting Dale Ajmere (Last) (First) 1955 BROADWAY	1. Name and Address of Reporting Dale Ajmere (Last) (First) 1955 BROADWAY	1. Name and Address of Reporting Dale Ajmere (Last) (First) 1955 BROADWAY	1. Name and Address of Reporting Dale Ajmere (Last) (First) 1955 BROADWAY	Person* (Middle)	Person* (Middle)	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ] 3. Date of Earliest Transaction (Month/Day/Year) 04/26/2023	2. Issuer NameandTicker or Trading Symbol Block, Inc. [ SQ] 3. Date of Earliest Transaction (Month/Day/Year) 04/26/2023	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director 10% Owner X Officer (give title below) Other (specify below) Chief Accounting Offcer	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director 10% Owner X Officer (give title below) Other (specify below) Chief Accounting Offcer
	SUITE 600					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
(Street) OAKLAND		CA		94612					Form filed by More than One Reporting Person
						Rule 10b5-1(c) Transaction Indication
	(City)	(State)		(Zip)

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.

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of	Security (Instr. 3)	Security (Instr. 3)	2. Transaction	2. Transaction	2A. Deemed	2A. Deemed	3.		4. Securities Acquired	4. Securities Acquired	(A) or	5. Amount of	5. Amount of	6. Ownership	6. Ownership	6. Ownership	7. Nature
			Date		Execution Date,		Transaction		Disposed Of (D) (Instr.		3, 4 and	Securities		Form: Direct			of Indirect
			(Month/Day/Year)		if any		Code (Instr.		5)			Beneficially		(D)	or		Beneficial
					(Month/Day/Year)		8)					Owned		Indirect (I)			Ownership
												Following		(Instr.		4)	(Instr. 4)
							Code	V	Amount	(A) or (D)	Price	Reported Transaction(s) (Instr. 3 and 4)
Class A Common Stock			04/26/2023				A		28,741 (1) (2) A		$ 0.00	74,746			D
		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			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.

2. 1/16th of the RSUs will vest on May 20, 2023 and each three months thereafter through February 20, 2027.

Remarks:

/s/ Susan Szotek, Attorney-in04/28/2023 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.

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/1512673/000120919123026126/xslF345X04/doc4.xml

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