Form4insider filings, from the source

SEC Form 4 · accession 0001104659-15-081150

Block, Inc. · XYZ

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owners
Suhail Rizvi
10% Owner
Period of report
Nov 24, 2015
Accepted (ET)
Nov 24, 2015 · 4:52 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001512673

Table I — non-derivative securities

SecurityDateCodeSharesPriceA/DOwned afterD/INature of ownership
Common StockF1,F2Nov 24, 2015C87,420—A87,420ISee footnote
Common StockF1,F3Nov 24, 2015C17,560—A17,560ISee footnote
Common StockF1,F4Nov 24, 2015C249,500—A249,500ISee footnote
Common StockF1,F5Nov 24, 2015C59,250—A59,250ISee footnote
Common StockF1,F6Nov 24, 2015C40,210—A40,210ISee footnote
Common StockF7,F2Nov 24, 2015J87,420—D0ISee footnote
Common StockF7,F3Nov 24, 2015J17,560—D0ISee footnote
Common StockF7,F4Nov 24, 2015J249,500—D0ISee footnote
Common StockF7,F5Nov 24, 2015J59,250—D0ISee footnote
Common StockF7,F6Nov 24, 2015J40,210—D0ISee footnote

Table II — derivative securities

SecurityConv. / exercise priceDateCodeSharesA/DExercisableExpiresUnderlyingUnderlying sharesOwned afterD/I
Series D Preferred StockF2,F1—Nov 24, 2015C87,420D——Common Stock87,4200I
Series D Preferred StockF3,F1—Nov 24, 2015C17,560D——Common Stock17,5600I
Series D Preferred StockF4,F1—Nov 24, 2015C249,500D——Common Stock249,5000I
Series D Preferred StockF5,F1—Nov 24, 2015C59,250D——Common Stock59,2500I
Series D Preferred StockF6,F1—Nov 24, 2015C40,210D——Common Stock40,2100I
Class B Common StockF7,F8,F2—Nov 24, 2015J87,420A——Class A Common Stock87,42087,420I
Class B Common StockF7,F8,F3—Nov 24, 2015J17,560A——Class A Common Stock17,56017,560I
Class B Common StockF7,F8,F4—Nov 24, 2015J249,500A——Class A Common Stock249,500249,500I
Class B Common StockF7,F8,F5—Nov 24, 2015J59,250A——Class A Common Stock59,25059,250I
Class B Common StockF7,F8,F6—Nov 24, 2015J40,210A——Class A Common Stock40,21040,210I

Explanation of responses

Remarks

This report is filed as one of three to report related transactions for the following filers: Rizvi Traverse Management, LLC; John Giampetroni; Suhail Rizvi; Rizvi Opportunistic Equity Fund, L.P.; Rizvi Opportunistic Equity Fund (TI), L.P.; Rizvi Opportunistic Equity Fund I-B, L.P.; Rizvi Opportunistic Equity Fund I-B (TI), L.P.; Rizvi Traverse Partners, LLC; Rizvi Traverse Management II, LLC; Rizvi Opportunistic Equity Fund II, L.P.; Rizvi Traverse Partners II, LLC; RT-SQ Management, LLC; RT Spartan IV, LLC; RT SQ Co-Invest, LLC; Rizvi Traverse CI GP, LLC; RT SQ Secondary, LLC; RT SQ Co-Invest II, LLC; RT-SQ TS, LLC; and RT SQ Special Opportunities, LLC.