SEC Form 4 · accession 0001209191-18-026729
Block, Inc. · XYZ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sivan Whiteley
Officer — Gen. Counsel & Corp. Secretary
Period of report
Apr 25, 2018
Accepted (ET)
Apr 27, 2018 · 7:10 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 25, 2018 | A | 16,695 | $0.00 | A | 126,275 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F2 | $44.75 | Apr 25, 2018 | A | 47,699 | A | — | Apr 24, 2028 | Class A Common Stock | 47,699 | 47,699 | D |
Explanation of responses
- F1Each share represents a restricted stock award (RSA). 2.5% of the RSAs will vest on July 1, 2018 and each three month anniversary thereafter through April 1, 2019, and 7.5% of the RSAs will vest on July 1, 2019 and each three month anniversary thereafter through April 1, 2022.
- F21/12 of 10% of the Shares subject to the Option will vest on May 1, 2018 and each month thereafter through April 1, 2019, and 1/36 of 90% of the shares subject to the Option will vest each month thereafter through April 1, 2022.