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Block, Inc. Director's Dealing 2024

Jul 3, 2024

30034_rns_2024-07-03_d2cbd948-1537-4eec-8904-e1823d9b77c8.pdf

Director's Dealing

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7/3/24, 1:57 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[[*]]

  2. Name and Address of Reporting Person[[]] 2. Issuer Name and* Ticker or Trading Symbol 5. Relationship of Reporting Person(s) to Issuer BOTHA ROELOF Block, Inc. [ SQ ] (Check all applicable) X Director 10% Owner Officer (give title Other (specify (Last) (First) (Middle) 3. Date of Earliest Transaction (Month/Day/Year) below) below) 07/01/2024 C/O SEQUOIA CAPITAL, 2800 SAND HILL ROAD SUITE 101 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) MENLO PARK CA 94025 Form filed by More than One Reporting Person (City) (State) (Zip)

  3. 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

for the purchase or sale of equity
securities of the issuer that is
intended to satisfy the affirmative
defense conditions of Rule 10b5-
1(c). See Instruction 10.
for the purchase or sale of equity
securities of the issuer that is
intended to satisfy the affirmative
defense conditions of Rule 10b5-
1(c). See Instruction 10.
1. Name and Address of Reporting Person*
BOTHA ROELOF
(Last)
(First)
(Middle)
C/O SEQUOIA CAPITAL, 2800 SAND HILL
ROAD
SUITE 101
(Street)
MENLO PARK
CA
94025
(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)
3. Date of Earliest Transaction (Month/Day/Year)
07/01/2024
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 07/01/2024 A 213
(1)
A $ 0 29,764 D
Class A Common Stock 1,862 I Sequoia
Capital
U.S.
Growth
Fund IV,
L.P.
(2)
Class A Common Stock 77 I Sequoia
Capital
USGF
Principals
Fund IV,
L.P.
(2)
Class A Common Stock 684,741 I By estate
planning
vehicle
Class A Common Stock 11,388 I Sequoia
Capital
U.S.
Venture
Fund XV,
L.P.
(3)
Class A Common Stock 479 I Sequoia
Capital
U.S.
Venture
Partners
Fund XV
(Q), L.P.
(3)

https://www.sec.gov/Archives/edgar/data/1222287/000162828024031146/xslF345X05/wk-form4_1720039771.xml

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SEC FORM 4

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

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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)
Code V Amount (A) or
(D)
Price
Class A Common Stock 171 I Sequoia
Capital
U.S.
Venture
Partners
Fund XV,
L.P.
(3)
Class A Common Stock 1,750 I Sequoia
Capital
U.S.
Venture
XV
Principals
Fund, L.P.
(3)
Class A Common Stock 540,646 I Sequoia
Capital
US/E
Expansion
Fund I,
L.P.
(4)
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 Reporting Person is a director and stockholder of SC US (TTGP), Ltd. SC US (TTGP), Ltd. is the general partner of SCGF IV Management,L.P., which is the general partner of Sequoia Capital U.S. Growth Fund IV, L.P. and Sequoia Capital USGF Principals Fund IV, L.P., or collectively, the SC GFIV Funds. The Reporting Person disclaims beneficial ownership of the securities held by the SC GFIV Funds except to the extent of his 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.

  3. The Reporting Person is a director and stockholder of SC US (TTGP), Ltd. SC US (TTGP), Ltd. is the general partner of SC U.S. Venture XV Management, L.P., which is the general partner of Sequoia Capital U.S. Venture Fund XV, L.P., Sequoia Capital U.S. Venture Partners Fund XV (Q), L.P., Sequoia Capital U.S. Venture Partners Fund XV, L.P. and Sequoia Capital U.S. Venture XV Principals Fund, L.P., or collectively, the SC USV XV Funds. The Reporting Person disclaims beneficial ownership of the securities held by the SC USV XV Funds except to the extent of his 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.

  4. The Reporting Person is a director and stockholder of SC US (TTGP), Ltd. SC US (TTGP), Ltd. is the general partner of SC US/E Expansion Fund I Management, L.P., which is the general partner of Sequoia Capital US/E Expansion Fund I, L.P. The Reporting Person disclaims beneficial ownership of the securities held by SC US/E Expansion Fund I Management, L.P. except to the extent of his 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-in07/03/2024 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/1222287/000162828024031146/xslF345X05/wk-form4_1720039771.xml

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