SEC Form 4 · accession 0001209191-17-062449
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
Nov 21, 2017
Accepted (ET)
Nov 24, 2017 · 3:28 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, 2017 | A | 917 | $10.23 | A | 355,566 | D | |
| Class A Common StockF3 | Nov 21, 2017 | C | 38,400 | $0.00 | D | 38,400 | I | See Footnote |
| Class A Common StockF5,F3 | Nov 21, 2017 | S | 7,100 | $46.57 | D | 31,300 | I | See Footnote |
| Class A Common StockF6,F3 | Nov 21, 2017 | S | 10,900 | $47.24 | D | 20,400 | I | See Footnote |
| Class A Common StockF7,F3 | Nov 21, 2017 | S | 1,200 | $47.99 | D | 19,200 | I | See Footnote |
| Class A Common StockF8,F3 | Nov 22, 2017 | S | 8,300 | $47.08 | D | 10,900 | I | See Footnote |
| Class A Common StockF9,F3 | Nov 22, 2017 | S | 9,000 | $47.55 | D | 1,900 | I | See Footnote |
| Class A Common StockF10,F3 | Nov 22, 2017 | S | 1,900 | $48.56 | D | 0 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class B Common StockF3,F11 | — | Nov 21, 2017 | C | 38,400 | D | — | — | Class A Common Stock | 38,400 | 454,716 | I |
| Class B Common StockF12,F11 | — | holding | — | — | — | — | — | Class A Common Stock | 548,453 | 548,453 | I |
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).
- F10The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $48.30 to $48.94 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.
- F11Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date.
- F12The shares are held of record by The Sarah Friar 2015 GRAT, dated August 6, 2015, for which the Reporting Person serves as a trustee.
- F2Represents the conversion of Class B Common Stock into Class A Common Stock 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.
- F3The shares are held of record by the Revocable Trust.
- F4The sales reported on this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the Revocable Trust.
- F5The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $45.90 to $46.89 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.
- F6The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $46.90 to $47.76 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.
- F7The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $47.90 to $48.18 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.
- F8The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $46.30 to $47.29 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.
- F9The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $47.30 to $48.15 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.