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Block, Inc. Director's Dealing 2023

Jan 5, 2023

30034_rns_2023-01-05_784d3fde-72b4-4ecd-b2e0-798a54aabc30.pdf

Director's Dealing

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1/5/23, 2:47 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

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

  1. Name and Address of Reporting Person[[*]]

  2. Name and Address of Reporting Person[[]] 2. Issuer Name and* Ticker or Trading Symbol Block, Inc. [ SQ ]

Dale Ajmere

  1. Relationship of Reporting Person(s) to Issuer (Check all applicable)

Director 10% Owner X Officer (give title Other (specify below) below)

X

(Last) (First) (Middle) 3. Date of Earliest Transaction (Month/Day/Year) below) below)
1455 MARKET STREET 01/03/2023 Chief Accounting Offcer
SUITE 600
4. If Amendment, Date of Original Filed (Month/Day/Year) 6. Individual or Joint/Group Filing (Check Applicable
(Street) 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
Date Execution Date, Transaction Disposed Of (D) (Instr. 3, 4 Securities Form: Direct of Indirect
(Month/Day/Year) if any Code (Instr. and 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 11/15/2022 A V 2
(1)
A $ 62.37 47,924 D
Class A Common Stock 01/03/2023 S 1,032
(2)
D $ 64.28 46,892 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 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 Reported
Disposed 4) 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. 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).

  2. 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 01/05/2023 ** 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/1512673/000120919123002000/xslF345X03/doc4.xml

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