SEC Form 4 · accession 0001209191-17-055416
Block, Inc. · XYZ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Hillary B Smith
Officer — Gen. Counsel & Corp. Secretary
Period of report
Oct 1, 2017
Accepted (ET)
Oct 3, 2017 · 6:26 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 1, 2017 | F | 1,039 | $28.81 | D | 642,154 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents shares that have been withheld by the Issuer to satisfy its income tax and withholding and remittance obligations in connection with the net settlement of restricted stock units and does not represent a sale by the Reporting Person.