Lawrence Henry Summers - 10 Dec 2021 Form 4 Insider Report for Block, Inc. (XYZ)

Role
Director
Signature
/s/ Susan Szotek, Attorney-in-Fact
Issuer symbol
XYZ
Transactions as of
10 Dec 2021
Net transactions value
$0
Form type
4
Filing time
14 Dec 2021, 17:01:28 UTC
Previous filing
27 Oct 2021
Next filing
30 Dec 2021
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction SQ Class A Common Stock Conversion of derivative security $0 +10,215 +47% $0.000000 31,871 10 Dec 2021 Direct F1
transaction SQ Class A Common Stock Gift $0 -10,215 -32% $0.000000 21,656 10 Dec 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 Conversion of derivative security $0 -10,215 -13% $0.000000 67,380 10 Dec 2021 Class A Common Stock 10,215 Direct F1, F2
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person.
F2 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.