0001209191-18-049108.txt : 20180831 0001209191-18-049108.hdr.sgml : 20180831 20180831170424 ACCESSION NUMBER: 0001209191-18-049108 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180829 FILED AS OF DATE: 20180831 DATE AS OF CHANGE: 20180831 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Summers Lawrence Henry CENTRAL INDEX KEY: 0001626636 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37622 FILM NUMBER: 181050629 MAIL ADDRESS: STREET 1: 207 FISHER AVENUE CITY: BROOKLINE STATE: MA ZIP: 02445 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Square, Inc. CENTRAL INDEX KEY: 0001512673 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 800429876 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1455 MARKET STREET STREET 2: SUITE 600 CITY: SAN FRANCISCO STATE: CA ZIP: 94103 BUSINESS PHONE: 415-375-3176 MAIL ADDRESS: STREET 1: 1455 MARKET STREET STREET 2: SUITE 600 CITY: SAN FRANCISCO STATE: CA ZIP: 94103 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-08-29 0 0001512673 Square, Inc. SQ 0001626636 Summers Lawrence Henry 1455 MARKET STREET SUITE 600 SAN FRANCISCO CA 94103 1 0 0 0 Class A Common Stock 14441 D Class A Common Stock 27382 I See Footnote Class B Common Stock 2018-08-29 5 G 0 E 37163 0.00 D Class A Common Stock 37163 163856 I See Footnote Class B Common Stock 2018-08-29 5 G 0 E 37163 0.00 A Class A Common Stock 37163 37163 D The shares are held of record by LHS 2017 Qualified Annuity Trust - Square, for which the Reporting Person serves as trustee. 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. /s/ Jason Gao, Attorney-in-Fact 2018-08-31