James Morgan McKelvey Jr. - Dec 10, 2021 Form 4 Insider Report for Block, Inc. (SQ)

Role
Director
Signature
/s/ Susan Szotek, Attorney-in-Fact
Stock symbol
SQ
Transactions as of
Dec 10, 2021
Transactions value $
$0
Form type
4
Date filed
12/14/2021, 04:42 PM
Previous filing
Oct 5, 2021
Next filing
Jan 5, 2022

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction SQ Class A Common Stock Gift $0 -50K -28.57% $0.00 125K Dec 10, 2021 See Footnote F1, F2
transaction SQ Class A Common Stock Gift $0 +50K +1280.08% $0.00 53.9K Dec 10, 2021 Direct F1
transaction SQ Class A Common Stock Conversion of derivative security $0 +372K +690.44% $0.00 426K Dec 10, 2021 Direct F3
transaction SQ Class A Common Stock Gift $0 -425K -99.74% $0.00 1.1K Dec 10, 2021 Direct

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction SQ Class B Common Stock Gift $0 -372K -2.95% $0.00 12.3M Dec 10, 2021 Class A Common Stock 372K See Footnote F4, F5
transaction SQ Class B Common Stock Gift $0 +372K $0.00 372K Dec 10, 2021 Class A Common Stock 372K Direct F4
transaction SQ Class B Common Stock Conversion of derivative security $0 -372K -100% $0.00* 0 Dec 10, 2021 Class A Common Stock 372K Direct F3, F4
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 This transaction involved a gift of shares by a trust for the benefit of the Reporting Person's spouse to the Reporting Person.
F2 The shares are held by the Anna Elefteria Ntenta Trust, dated 11/30/2017, for the benefit of the Reporting Person's spouse.
F3 Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person.
F4 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.
F5 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.