0001209191-20-064806.txt : 20201222 0001209191-20-064806.hdr.sgml : 20201222 20201222151804 ACCESSION NUMBER: 0001209191-20-064806 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201218 FILED AS OF DATE: 20201222 DATE AS OF CHANGE: 20201222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McKelvey James Morgan Jr. CENTRAL INDEX KEY: 0001658460 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37622 FILM NUMBER: 201407800 MAIL ADDRESS: STREET 1: 2645 SOUTH BAYSHORE #802 CITY: MIAMI STATE: FL ZIP: 33133 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 2020-12-18 0 0001512673 Square, Inc. SQ 0001658460 McKelvey James Morgan Jr. 1455 MARKET STREET SUITE 600 SAN FRANCISCO CA 94103 1 0 0 0 Class A Common Stock 2020-12-18 4 C 0 223131 0.00 A 302638 D Class A Common Stock 2020-12-18 5 G 0 E 300000 0.00 D 2638 D Class A Common Stock 175000 I See Footnote Class B Common Stock 2020-12-18 4 C 0 223131 0.00 D Class A Common Stock 223131 1183869 D Class B Common Stock Class A Common Stock 13047347 13047347 I See Footnote Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person. The shares are held by the Anna Elefteria Ntenta Trust, dated 11/30/2017, for the benefit of the Reporting Person's spouse. 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. 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. /s/ Shahzia Rahman, Attorney-in-Fact 2020-12-22