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Block, Inc. Director's Dealing 2024

Jun 23, 2024

30034_rns_2024-06-23_e246f568-a46f-4732-8e9f-5ddd120688e3.pdf

Director's Dealing

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6/21/24, 3:05 PM

SEC FORM 4

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

OMB APPROVAL

Washington, D.C. 20549

OMB Number: 3235-0287 Estimated average burden hours per response: 0.5

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

OMB APPROVAL OMB APPROVAL OMB APPROVAL OMB APPROVAL OMB APPROVAL OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
STATEME
File
Check this box if no longer subject to
Section 16. Form 4 or Form 5
obligations may continue.See
Instruction 1(b).
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 10b5-1(c). See
Instruction 10.
T OF CHANGES IN BENEFICIAL OWNERSHIP
d pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
hours per response:
0.5
1. Name and Address of Reporting Person*
McKelvey James Morgan Jr.
(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)
3. Date of Earliest Transaction (Month/Day/Year)
06/18/2024
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 06/18/2024 A 4,038
(1)
A $ 0 14,498 D
Class A Common Stock 125,000 I See
Footnote
(2)
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
Class B
Common
(3) (3) (3) Class A
Common
Stock
12,259,025 I See
Footnote
(4)
12,259,025
Stock
(3)

Explanation of Responses:

  1. Represents an automatic annual restricted stock unit (RSU) award issued pursuant to the Issuer's Outside Director Compensation Policy. Each RSU represents a contingent right to receive one share of Issuer's Class A Common Stock upon settlement. 100% of the RSUs vest on the earlier of June 18, 2025, or the date of the Issuer's next annual meeting of stockholders.

  2. The shares are held by the Anna Elefteria Ntenta Trust, dated 11/30/2017, for the benefit of the Reporting Person's spouse.

  3. Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date.

  4. The shares are held of record by the James McKelvey, Jr. Revocable Trust dated July 2, 2014, for which the Reporting Person serves as a Trustee.

Remarks:

/s/ Susan Szotek, Attorney-in06/21/2024 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/1512673/000162828024029388/xslF345X05/wk-form4_1719007152.xml

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