SEC Form 4 · accession 0001209191-16-147182
Block, Inc. · XYZ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ajmere Dale
Officer — Chief Accounting Officer
Period of report
Oct 25, 2016
Accepted (ET)
Oct 27, 2016 · 5:43 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001512673
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF1 | Oct 25, 2016 | A | 130,000 | $0.00 | A | 130,000 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Each share is represented by a restricted stock unit (RSU). Each RSU represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement. 25% of the RSUs vest on September 1, 2017, and 1/16 of the RSUs vest every three months thereafter.