0001209191-22-058878.txt : 20221128 0001209191-22-058878.hdr.sgml : 20221128 20221128170503 ACCESSION NUMBER: 0001209191-22-058878 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221123 FILED AS OF DATE: 20221128 DATE AS OF CHANGE: 20221128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Henry Alyssa CENTRAL INDEX KEY: 0001658470 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37622 FILM NUMBER: 221426405 MAIL ADDRESS: STREET 1: 1455 MARKET STREET STREET 2: SUITE 600 CITY: SAN FRANCISCO STATE: CA ZIP: 94103 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Block, 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 FORMER COMPANY: FORMER CONFORMED NAME: Square, Inc. DATE OF NAME CHANGE: 20110210 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-11-23 0 0001512673 Block, Inc. SQ 0001658470 Henry Alyssa 1455 MARKET STREET SUITE 600 SAN FRANCISCO CA 94103 0 1 0 0 Square Lead Class A Common Stock 2022-11-23 4 C 0 30769 0.00 A 453386 D Class A Common Stock 2022-11-23 4 S 0 27522 62.53 D 425864 D Class A Common Stock 2022-11-23 4 S 0 3247 63.23 D 422617 D Stock Option (right to buy) 7.254 2022-11-23 4 M 0 30769 0.00 D 2024-05-14 Class B Common Stock 30769 707687 D Class B Common Stock 2022-11-23 4 M 0 30769 0.00 A Class A Common Stock 30769 30769 D Class B Common Stock 2022-11-23 4 C 0 30769 0.00 D Class A Common Stock 30769 0 D Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person. The option exercise and sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan. The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $61.99 to $62.98 per share. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $63.00 to $63.37 per share. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote. 25% of the shares subject to the option vested on May 12, 2015 and 1/48th of the shares vested monthly thereafter. 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/ Susan Szotek, Attorney-in-Fact 2022-11-28