Brian Grassadonia - 11 May 2022 Form 4 Insider Report for Block, Inc. (XYZ)

Role
Cash App Lead
Signature
/s/ Susan Szotek, Attorney-in-Fact
Issuer symbol
XYZ
Transactions as of
11 May 2022
Net transactions value
$0
Form type
4
Filing time
13 May 2022, 17:23:24 UTC
Previous filing
04 May 2022
Next filing
07 Jul 2022
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 +84,300 +48% $0.000000 261,380 11 May 2022 Direct F1

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 Stock Option (right to buy) Options Exercise $0 -84,300 -25% $0.000000 252,816 11 May 2022 Class B Common Stock 84,300 $7.25 Direct F2, F3
transaction SQ Class B Common Stock Options Exercise $0 +84,300 $0.000000 84,300 11 May 2022 Class A Common Stock 84,300 Direct F3
transaction SQ Class B Common Stock Conversion of derivative security $0 -84,300 -100% $0.000000* 0 11 May 2022 Class A Common Stock 84,300 Direct F1, F3
* 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 20% of the shares subject to the option vested on February 24, 2015 and 1/60th of the shares vested monthly thereafter.
F3 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.