Block Head and Chairperson Dorsey Jack gifted 2,391 shares and received a gift of 2,391 shares (SEC Form 4)
$XYZ
Computer Software: Prepackaged Software
Technology
| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
| Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Block, Inc. [ XYZ ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 05/30/2025 | ||||||||||||||||||||||||||
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4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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| 1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
| Code | V | Amount | (A) or (D) | Price | ||||||
| Class A Common Stock | 05/30/2025 | G | 2,391 | D | $0 | 0 | I | See Footnote(1)(2)(3) | ||
| Class A Common Stock | 05/30/2025 | G | 2,391 | A | $0 | 2,391 | I | See Footnote(4) | ||
| Class A Common Stock | 287,155 | I | See Footnote(1)(2)(5) | |||||||
| Class A Common Stock | 710,454 | I | See Footnote(1)(2)(6) | |||||||
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
| Class B Common Stock(7) | (7) | (7) | (7) | Class A Common Stock | 35,763,992 | 35,763,992 | I | See Footnote(8) | |||||||
| Class B Common Stock(7) | (7) | (7) | (7) | Class A Common Stock | 12,080,574 | 12,080,574 | I | See Footnote(9) | |||||||
| Explanation of Responses: |
| 1. Since the date of the Reporting Person's last Form 4 filing, a total of 1,000,000 shares of Class A Common Stock previously held of record by the Jack Dorsey 2022 Annuity Trust, a grantor retained annuity trust for which the Reporting Person served as Co-Trustee (the "2022 Trust"), were transferred to and/or among (i) the Jack Dorsey Revocable Trust u/a/d 12/8/10, for which the Reporting Person serves as a Trustee (the "2010 Trust"), (ii) the Jack Dorsey and A7P Trust Company Inc Tr UA 05/26/2023, for which the Reporting Person serves as Trustee (the "2023 Trust"), (iii) the Jack Dorsey and A7P Trust Company Inc Tr UA 05/28/2024, for which the Reporting Person serves as Trustee (the "2024 Trust"), and (iv) the Jack Dorsey and A7P Trust Company Inc as Co-Trustees, Dated May 28, 2025, for which the Reporting Person serves as Trustee (the "2025 Trust") (continued at footnote 2 below). |
| 2. None of such transfers resulted in a change in beneficial ownership. In addition, a portion of such shares were transferred from the 2023 Trust to a trust in which the Reporting Person may be deemed to have a pecuniary interest. Following the transfers described in footnotes 1 and 2, no shares were held by the 2022 Trust or the 2023 Trust. |
| 3. The shares are held of record by the 2023 Trust. |
| 4. The shares are held of record by a trust in which the Reporting Person may be deemed to have a pecuniary interest. The Reporting Person disclaims beneficial ownership of these shares, except to the extent of his pecuniary interest therein. |
| 5. The shares are held of record by the 2024 Trust. |
| 6. The shares are held of record by the 2025 Trust. |
| 7. Each 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. |
| 8. The shares are held of record by the 2010 Trust. |
| 9. The shares are held of record by Start Small, LLC, for which the Reporting Person is the sole member. |
| Remarks: |
| /s/ Susan Szotek, Attorney-in-Fact | 06/03/2025 | |
| ** Signature of Reporting Person | Date | |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
| * If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
| ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
| Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. | ||