SEC Form 4 · accession 0001209191-16-150990
Block, Inc. · XYZ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Francoise Brougher
Officer — Business Lead
Period of report
Nov 15, 2016
Accepted (ET)
Nov 17, 2016 · 6:42 pm EST
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 | Nov 15, 2016 | A | 2,042 | $7.65 | A | 102,175 | D | |
| Class A Common StockF2 | Nov 16, 2016 | S | 2,042 | $11.8269 | D | 100,133 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1These shares were acquired under the Issuer's Employee Stock Purchase Plan in a transaction that was exempt under both Rule 16b-3(d) and Rule 16b-3(c).
- F2The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $11.77 to $11.8617 per share. The Reporting Person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.