Block, Inc. — Director's Dealing 2023

Jan 5, 2023

1/5/23, 2:28 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

1. Name and Address of Reporting Person* Meeker Mary G	1. Name and Address of Reporting Person* Meeker Mary G	1. Name and Address of Reporting Person* Meeker Mary G		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	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner	5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner
	(Last)	(First)	(Middle)	3. Date of Earliest 01/03/2023				Transaction (Month/Day/Year)								Officer (give title below)				Other (specify below)
	1455 MARKET STREET
	SUITE 600
				4. If Amendment, Date					of Original		Filed (Month/Day/Year)			6. Individual or Joint/Group Filing (Check Applicable
(Street)														Line) X		Form filed		by One Reporting Person
	SAN FRANCISCO CA		94103													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				01/03/2023						A		218 (1)	A	$ 0.00		406,467			D
																					See
Class A Common Stock																	5,817			I	Footnote (2)

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. 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-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/1512673/000120919123001964/xslF345X03/doc4.xml

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