SEC Form 4 · accession 0001209191-17-028796
Block, Inc. · XYZ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sarah Friar
Officer — Chief Financial Officer
Period of report
Apr 26, 2017
Accepted (ET)
Apr 28, 2017 · 6:29 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 | Apr 26, 2017 | S | 2,696 | $18.23 | D | 373,220 | D | |
| Class A Common StockF2 | holding | — | — | — | 38,400 | I | See Footnotes |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents the number of shares automatically sold upon vesting of restricted stock units to cover tax withholding obligations.
- F2The shares are held of record by the David Riley and Sarah Friar Revocable Trust dated August 11, 2006 (Revocable Trust), for which the Reporting Person serves as a trustee. The Reporting Person has sole dispositive power and voting control over the shares of the Issuer held by the Revocable Trust.