Jack Dorsey - 30 May 2025 Form 4 Insider Report for Block, Inc. (XYZ)

Reporting relationship: Block Head and Chairperson, Director, 10%+ Owner
Issuer ticker: XYZ
Reported as of: 30 May 2025
Net transaction value: $0
SEC form: 4
Accepted by SEC: 03 Jun 2025, 17:07:36 UTC
Prior SEC filing: 31 Oct 2022
Source filing: View source filing
Reporting owner signature: /s/ Susan Szotek, Attorney-in-Fact

Key filing fact

Jack Dorsey filed Form 4 for Block, Inc. (XYZ) on 03 Jun 2025.

Key facts

This page summarizes Jack Dorsey's Form 4 filing for Block, Inc. (XYZ).
2 reported transactions and 2 derivative rows are listed below.
Accepted by SEC: 03 Jun 2025, 17:07.

Change

Previous filing in this sequence was filed on 31 Oct 2022.
Current net transaction value: $0.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reporting Owners (1)

CIK 0001590945 Primary reporting owner

Dorsey Jack

Relationship: Block Head and Chairperson, Director, 10%+ Owner
Address: 1955 BROADWAY, SUITE 600, OAKLAND
Signature: /s/ Susan Szotek, Attorney-in-Fact
Signature date: 03 Jun 2025

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

XYZ transaction

Class A Common Stock

Gift

Transaction value: $0
Shares: -2,391
Change %: -100%
Price: $0.000000
Shares after: 0
Date: 30 May 2025
Ownership: See Footnote
Footnotes: F1, F2, F3

XYZ transaction

Class A Common Stock

Gift

Transaction value: $0
Shares: +2,391
Change %
Price: $0.000000
Shares after: 2,391
Date: 30 May 2025
Ownership: See Footnote
Footnotes: F4

XYZ holding

Class A Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 287,155
Date: 30 May 2025
Ownership: See Footnote
Footnotes: F1, F2, F5

XYZ holding

Class A Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 710,454
Date: 30 May 2025
Ownership: See Footnote
Footnotes: F1, F2, F6

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

XYZ holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 35,763,992
Date: 30 May 2025
Ownership: See Footnote
Underlying class: Class A Common Stock
Underlying amount: 35,763,992
Exercise price
Footnotes: F7, F8

XYZ holding Derivative

Class B Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 12,080,574
Date: 30 May 2025
Ownership: See Footnote
Underlying class: Class A Common Stock
Underlying amount: 12,080,574
Exercise price
Footnotes: F7, F9

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 9 footnotes

Footnote F1

Since the date of the Reporting Person's last Form 4 filing, a total of 1,000,000 shares of Class A Common Stock previously held of record by the Jack Dorsey 2022 Annuity Trust, a grantor retained annuity trust for which the Reporting Person served as Co-Trustee (the "2022 Trust"), were transferred to and/or among (i) the Jack Dorsey Revocable Trust u/a/d 12/8/10, for which the Reporting Person serves as a Trustee (the "2010 Trust"), (ii) the Jack Dorsey and A7P Trust Company Inc Tr UA 05/26/2023, for which the Reporting Person serves as Trustee (the "2023 Trust"), (iii) the Jack Dorsey and A7P Trust Company Inc Tr UA 05/28/2024, for which the Reporting Person serves as Trustee (the "2024 Trust"), and (iv) the Jack Dorsey and A7P Trust Company Inc as Co-Trustees, Dated May 28, 2025, for which the Reporting Person serves as Trustee (the "2025 Trust") (continued at footnote 2 below).

Footnote F2

None of such transfers resulted in a change in beneficial ownership. In addition, a portion of such shares were transferred from the 2023 Trust to a trust in which the Reporting Person may be deemed to have a pecuniary interest. Following the transfers described in footnotes 1 and 2, no shares were held by the 2022 Trust or the 2023 Trust.

Footnote F3

The shares are held of record by the 2023 Trust.

Footnote F4

The shares are held of record by a trust in which the Reporting Person may be deemed to have a pecuniary interest. The Reporting Person disclaims beneficial ownership of these shares, except to the extent of his pecuniary interest therein.

Footnote F5

The shares are held of record by the 2024 Trust.

Footnote F6

The shares are held of record by the 2025 Trust.

Footnote F7

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.

Footnote F8

The shares are held of record by the 2010 Trust.

Footnote F9

The shares are held of record by Start Small, LLC, for which the Reporting Person is the sole member.